Provider Demographics
NPI:1598457749
Name:ACTON, EMMA (OD)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:
Last Name:ACTON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7182 OAK TRACE LN
Mailing Address - Street 2:
Mailing Address - City:BROWNSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:46112-7035
Mailing Address - Country:US
Mailing Address - Phone:317-902-8740
Mailing Address - Fax:
Practice Address - Street 1:900 EDWARDS DR
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IN
Practice Address - Zip Code:46168-5680
Practice Address - Country:US
Practice Address - Phone:317-839-2368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-25
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN390200000X152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist