Provider Demographics
NPI:1417116963
Name:MCDANIEL FAMILY EYE CARE, PC
Entity Type:Organization
Organization Name:MCDANIEL FAMILY EYE CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:MCDANIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-398-0305
Mailing Address - Street 1:441 AMOS RD
Mailing Address - Street 2:PO BOX 200
Mailing Address - City:SHELBYVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46176-2245
Mailing Address - Country:US
Mailing Address - Phone:317-398-0305
Mailing Address - Fax:317-398-3116
Practice Address - Street 1:441 AMOS RD
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:IN
Practice Address - Zip Code:46176-2245
Practice Address - Country:US
Practice Address - Phone:317-398-0305
Practice Address - Fax:317-398-3116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-09
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty