Provider Demographics
NPI:1568439784
Name:DAVID I MALITZ MD., PC
Entity Type:Organization
Organization Name:DAVID I MALITZ MD., PC
Other - Org Name:SOUTHWEST EYE INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:I
Authorized Official - Last Name:MALITZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:812-421-2020
Mailing Address - Street 1:1001 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47713-1963
Mailing Address - Country:US
Mailing Address - Phone:812-421-2020
Mailing Address - Fax:812-422-1189
Practice Address - Street 1:8981 W SAHARA AVE STE 270
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-5894
Practice Address - Country:US
Practice Address - Phone:702-362-3900
Practice Address - Fax:702-362-7405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-07
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty