Provider Demographics
NPI:1598840803
Name:DR HOLLY LEWTON PC
Entity Type:Organization
Organization Name:DR HOLLY LEWTON PC
Other - Org Name:96TH STREET EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:LEWTON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:317-585-9800
Mailing Address - Street 1:9605 E 96TH STREET
Mailing Address - Street 2:1100
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-3302
Mailing Address - Country:US
Mailing Address - Phone:317-585-9800
Mailing Address - Fax:317-585-9823
Practice Address - Street 1:9605 E 96TH STREET
Practice Address - Street 2:1100
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-3302
Practice Address - Country:US
Practice Address - Phone:317-585-9800
Practice Address - Fax:317-585-9823
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty