Provider Demographics
NPI:1184049504
Name:HEDGES FAMILY EYECARE, PC
Entity type:Organization
Organization Name:HEDGES FAMILY EYECARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:HEDGES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-745-4546
Mailing Address - Street 1:502 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46122-1626
Mailing Address - Country:US
Mailing Address - Phone:317-745-4546
Mailing Address - Fax:317-745-0513
Practice Address - Street 1:502 W MAIN ST
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:IN
Practice Address - Zip Code:46122-1626
Practice Address - Country:US
Practice Address - Phone:317-745-4546
Practice Address - Fax:317-745-0513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-21
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty