Provider Demographics
NPI:1588192157
Name:PANKRATZ MEDICAL LLC
Entity Type:Organization
Organization Name:PANKRATZ MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:PANKRATZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-373-7777
Mailing Address - Street 1:401 COMMERCE ST STE 600
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37219-2518
Mailing Address - Country:US
Mailing Address - Phone:615-345-6900
Mailing Address - Fax:
Practice Address - Street 1:3135 MIDDLE DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47203-4472
Practice Address - Country:US
Practice Address - Phone:812-373-7777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-26
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty