Provider Demographics
NPI:1528188901
Name:FISHERS FAMILY VISION CENTER INC
Entity Type:Organization
Organization Name:FISHERS FAMILY VISION CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:P
Authorized Official - Last Name:SIGLER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:317-578-2020
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN=========OtherVSP
IN=========OtherEYEMED
IN=========OtherCOMP BENEFITS