Provider Demographics
NPI:1659489367
Name:BARRETT EYE CARE, LLC
Entity Type:Organization
Organization Name:BARRETT EYE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-872-8772
Mailing Address - Street 1:11450 N MERIDIAN STREET
Mailing Address - Street 2:STE 120
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-4688
Mailing Address - Country:US
Mailing Address - Phone:317-872-8772
Mailing Address - Fax:317-573-6322
Practice Address - Street 1:11845 ALLISONVILLE RD
Practice Address - Street 2:SUITE #300
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-2313
Practice Address - Country:US
Practice Address - Phone:317-585-9295
Practice Address - Fax:317-573-6322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-25
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200889580Medicaid
220390Medicare PIN
IN200889580Medicaid
5924340002Medicare NSC