Provider Demographics
NPI:1639455066
Name:MIDWEST CORNEA ASSOCIATES, LLC
Entity Type:Organization
Organization Name:MIDWEST CORNEA ASSOCIATES, LLC
Other - Org Name:INVISION LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JAYME
Authorized Official - Middle Name:
Authorized Official - Last Name:GEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-805-4509
Mailing Address - Street 1:10300 N ILLINOIS ST STE 1040
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46290-1167
Mailing Address - Country:US
Mailing Address - Phone:317-817-1765
Mailing Address - Fax:317-817-1767
Practice Address - Street 1:10300 N ILLINOIS ST STE 1040
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46290-1167
Practice Address - Country:US
Practice Address - Phone:317-817-1765
Practice Address - Fax:317-817-1767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-31
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201052680AMedicaid
IN201052680AMedicaid