Provider Demographics
NPI:1801002522
Name:MIDWEST EYE CONSULTANTS, P.C.
Entity Type:Organization
Organization Name:MIDWEST EYE CONSULTANTS, P.C.
Other - Org Name:CATARACT & LASER INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRES./CEO
Authorized Official - Prefix:
Authorized Official - First Name:GREGRORY
Authorized Official - Middle Name:L
Authorized Official - Last Name:GARNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:260-569-9550
Mailing Address - Street 1:PO BOX 6550
Mailing Address - Street 2:
Mailing Address - City:KOKOMO
Mailing Address - State:IN
Mailing Address - Zip Code:46904-6550
Mailing Address - Country:US
Mailing Address - Phone:765-453-5696
Mailing Address - Fax:765-455-4323
Practice Address - Street 1:1601 W LINCOLN RD
Practice Address - Street 2:
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46902-3275
Practice Address - Country:US
Practice Address - Phone:765-453-5696
Practice Address - Fax:765-455-4323
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MIDWEST EYE CONSULTANTS, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-16
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207W00000X
IN17001243A332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No332S00000XSuppliersHearing Aid EquipmentGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300034470Medicaid
IN252690Medicare PIN
IN0317020029Medicare NSC
IN452570Medicare PIN
INCG7897Medicare PIN
IN200870630AMedicaid