Provider Demographics
NPI:1396033726
Name:IMAGE EYE CARE P C
Entity Type:Organization
Organization Name:IMAGE EYE CARE P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:K
Authorized Official - Last Name:RYAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:812-477-6243
Mailing Address - Street 1:5600 E VIRGINIA ST STE A
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715-2657
Mailing Address - Country:US
Mailing Address - Phone:812-477-6243
Mailing Address - Fax:812-303-6022
Practice Address - Street 1:5600 E VIRGINIA ST STE A
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-2657
Practice Address - Country:US
Practice Address - Phone:812-477-6243
Practice Address - Fax:812-303-6022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-19
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN56000412A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty