Provider Demographics
NPI:1356639843
Name:KEEN EYECARE CONSULTANTS INC.
Entity type:Organization
Organization Name:KEEN EYECARE CONSULTANTS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:F
Authorized Official - Last Name:SCHMITT
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:812-200-8112
Mailing Address - Street 1:PO BOX 8115
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47716-8115
Mailing Address - Country:US
Mailing Address - Phone:812-200-8112
Mailing Address - Fax:812-200-2823
Practice Address - Street 1:6436 E. FLORIDA STREET
Practice Address - Street 2:SUITE 102
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715
Practice Address - Country:US
Practice Address - Phone:812-200-8112
Practice Address - Fax:812-200-2823
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-18
Last Update Date:2024-04-03
Deactivation Date:2024-03-18
Deactivation Code:
Reactivation Date:2024-04-03
Provider Licenses
StateLicense IDTaxonomies
IN18003677A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty