Provider Demographics
NPI:1821284464
Name:OPTIKS LLC
Entity Type:Organization
Organization Name:OPTIKS LLC
Other - Org Name:RON HAWKINS O.D. DBA OPTIKS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RON
Authorized Official - Middle Name:
Authorized Official - Last Name:HAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:812-331-9082
Mailing Address - Street 1:101 W KIRKWOOD AVE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47404-6129
Mailing Address - Country:US
Mailing Address - Phone:812-331-9082
Mailing Address - Fax:812-331-1301
Practice Address - Street 1:101 W KIRKWOOD AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47404-6129
Practice Address - Country:US
Practice Address - Phone:812-331-9082
Practice Address - Fax:812-331-1301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-18
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000338080OtherANTHEM
000000539394OtherANTHEM
000000338080OtherANTHEM
INV11966Medicare UPIN
IN967140Medicare PIN
0525160001Medicare NSC
IN254030AMedicare PIN