Provider Demographics
NPI:1467587998
Name:SIGLER, SHAWN P (OD)
Entity Type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:P
Last Name:SIGLER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9536 E 126TH ST
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-2854
Mailing Address - Country:US
Mailing Address - Phone:317-578-2020
Mailing Address - Fax:317-578-7148
Practice Address - Street 1:9536 E 126TH ST
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-2854
Practice Address - Country:US
Practice Address - Phone:317-578-2020
Practice Address - Fax:317-578-7148
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18002432B152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN351883917OtherVISION SERVICE PLAN
IN351883917OtherVISION CARE, INC.
ININ2432OtherEYEMED
IN200066230Medicaid