Provider Demographics
NPI:1780886499
Name:ADVANCED EYE CARE, P.C.
Entity type:Organization
Organization Name:ADVANCED EYE CARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:C
Authorized Official - Last Name:BIGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:812-425-3365
Mailing Address - Street 1:634 CROSS VALLEY CIR
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47710-5238
Mailing Address - Country:US
Mailing Address - Phone:812-426-2256
Mailing Address - Fax:812-429-0392
Practice Address - Street 1:634 CROSS VALLEY CIR
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47710-5238
Practice Address - Country:US
Practice Address - Phone:812-426-2256
Practice Address - Fax:812-429-0392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-04
Last Update Date:2009-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18003181A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200394590Medicaid
IN193660Medicare ID - Type Unspecified
INU92401Medicare UPIN
IN200394590Medicaid