Provider Demographics
NPI:1245467877
Name:CHRISTIE, COLIN CRANE (OD)
Entity type:Individual
Prefix:DR
First Name:COLIN
Middle Name:CRANE
Last Name:CHRISTIE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5377 BROOKSTONE LN
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46142-7706
Mailing Address - Country:US
Mailing Address - Phone:317-987-8720
Mailing Address - Fax:
Practice Address - Street 1:6845 BLUFF RD
Practice Address - Street 2:SUITE #26
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46217-3926
Practice Address - Country:US
Practice Address - Phone:317-660-6445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-22
Last Update Date:2009-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18003580A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist