Provider Demographics
NPI:1780766642
Name:FOCUS EYECARE CENTER PC
Entity type:Organization
Organization Name:FOCUS EYECARE CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GRANT
Authorized Official - Middle Name:CAMERON
Authorized Official - Last Name:AMSTUTZ
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:812-944-9944
Mailing Address - Street 1:5120 CHARLESTOWN RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-9497
Mailing Address - Country:US
Mailing Address - Phone:812-944-9944
Mailing Address - Fax:812-944-8990
Practice Address - Street 1:5120 CHARLESTOWN RD
Practice Address - Street 2:SUITE 4
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-9497
Practice Address - Country:US
Practice Address - Phone:812-944-9944
Practice Address - Fax:812-944-8990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18003059A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty