Provider Demographics
NPI:1235307224
Name:GEOFFREY K. HEMMICK, OD
Entity Type:Organization
Organization Name:GEOFFREY K. HEMMICK, OD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:GEOFFREY
Authorized Official - Middle Name:K
Authorized Official - Last Name:HEMMICK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:260-894-3912
Mailing Address - Street 1:200 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LIGONIER
Mailing Address - State:IN
Mailing Address - Zip Code:46767-1902
Mailing Address - Country:US
Mailing Address - Phone:260-894-3912
Mailing Address - Fax:260-894-4098
Practice Address - Street 1:200 S MAIN ST
Practice Address - Street 2:
Practice Address - City:LIGONIER
Practice Address - State:IN
Practice Address - Zip Code:46767-1902
Practice Address - Country:US
Practice Address - Phone:260-894-3912
Practice Address - Fax:260-894-4098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-13
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1155950001Medicare NSC