Provider Demographics
NPI:1598917213
Name:VOSS, SERVILIA AUGUSTINA (OD)
Entity Type:Individual
Prefix:DR
First Name:SERVILIA
Middle Name:AUGUSTINA
Last Name:VOSS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2377 E MAIN ST STE 130
Mailing Address - Street 2:EYEGLASS WORLD
Mailing Address - City:PLAINFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46168-2717
Mailing Address - Country:US
Mailing Address - Phone:317-839-5658
Mailing Address - Fax:
Practice Address - Street 1:2377 E MAIN ST STE 130
Practice Address - Street 2:EYEGLASS WORLD
Practice Address - City:PLAINFIELD
Practice Address - State:IN
Practice Address - Zip Code:46168-2717
Practice Address - Country:US
Practice Address - Phone:317-839-5658
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-13
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18003527A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist