Provider Demographics
NPI:1962483248
Name:THE EYE CENTER GROUP LLC
Entity Type:Organization
Organization Name:THE EYE CENTER GROUP LLC
Other - Org Name:LAFAYETTE EYE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PART OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:S
Authorized Official - Last Name:RAPKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:765-286-8888
Mailing Address - Street 1:PO BOX 472
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47308-0472
Mailing Address - Country:US
Mailing Address - Phone:765-449-3937
Mailing Address - Fax:800-882-3939
Practice Address - Street 1:3746 ROME DR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47905-4489
Practice Address - Country:US
Practice Address - Phone:765-449-3937
Practice Address - Fax:800-882-3939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Not Answered207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN228780Medicare ID - Type Unspecified