Provider Demographics
NPI:1932535929
Name:HEARNE VISION CARE
Entity Type:Organization
Organization Name:HEARNE VISION CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KIRK
Authorized Official - Middle Name:A
Authorized Official - Last Name:HEARNE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:812-346-4646
Mailing Address - Street 1:130 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:NORTH VERNON
Mailing Address - State:IN
Mailing Address - Zip Code:47265-1724
Mailing Address - Country:US
Mailing Address - Phone:812-346-4646
Mailing Address - Fax:812-352-6262
Practice Address - Street 1:130 N STATE ST
Practice Address - Street 2:
Practice Address - City:NORTH VERNON
Practice Address - State:IN
Practice Address - Zip Code:47265-1724
Practice Address - Country:US
Practice Address - Phone:812-346-4646
Practice Address - Fax:812-352-6262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-23
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18002748A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200050860Medicaid
IN200050860Medicaid