Provider Demographics
NPI:1255653226
Name:CASSIDY EYE CARE, LLC
Entity Type:Organization
Organization Name:CASSIDY EYE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:R
Authorized Official - Last Name:CASSIDY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:317-773-8800
Mailing Address - Street 1:1806 CONNER ST
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-3052
Mailing Address - Country:US
Mailing Address - Phone:317-773-8800
Mailing Address - Fax:317-770-8694
Practice Address - Street 1:1806 CONNER ST
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-3052
Practice Address - Country:US
Practice Address - Phone:317-773-8800
Practice Address - Fax:317-770-8694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-18
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18003134A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty