Provider Demographics
NPI:1316039803
Name:SCHUETZ, KATHERINE GRACE (OD)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:GRACE
Last Name:SCHUETZ
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14250 CLAY TERRACE BLVD
Mailing Address - Street 2:STE 160
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-3633
Mailing Address - Country:US
Mailing Address - Phone:317-873-3393
Mailing Address - Fax:317-873-3323
Practice Address - Street 1:55 BRENDON WAY
Practice Address - Street 2:SUITE 900
Practice Address - City:ZIONSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46077-1961
Practice Address - Country:US
Practice Address - Phone:317-873-3393
Practice Address - Fax:317-873-3323
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18003070152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN309620475OtherVSP
IN000000366787OtherANTHEM
IN200476480AMedicaid