Provider Demographics
NPI:1639379878
Name:GIBSON COUNTY EYECARE INC
Entity Type:Organization
Organization Name:GIBSON COUNTY EYECARE INC
Other - Org Name:LINDA S. NEUHOFF OD PC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:RENAE
Authorized Official - Last Name:MCELLHINEY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:812-385-4857
Mailing Address - Street 1:516 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:IN
Mailing Address - Zip Code:47670-1406
Mailing Address - Country:US
Mailing Address - Phone:812-385-4857
Mailing Address - Fax:812-386-5770
Practice Address - Street 1:516 N MAIN ST
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:IN
Practice Address - Zip Code:47670-1406
Practice Address - Country:US
Practice Address - Phone:812-385-4857
Practice Address - Fax:812-386-5770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-24
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18002082A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201034100AMedicaid
IN201034100AMedicaid
INDG7970Medicare PIN
IN252490Medicare PIN
IN5988750001Medicare NSC