Basic Information
Provider Information
NPI: 1811049901
EntityType: 2
ReplacementNPI:  
OrganizationName: MEYER AND ASSOCIATES OPTOMETRY, PC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 160 LAKEVIEW DR
Address2:  
City: NOBLESVILLE
State: IN
PostalCode: 460601307
CountryCode: US
TelephoneNumber: 3177734482
FaxNumber: 3177762520
Practice Location
Address1: 160 LAKEVIEW DR
Address2:  
City: NOBLESVILLE
State: IN
PostalCode: 460601307
CountryCode: US
TelephoneNumber: 3177734482
FaxNumber: 3177703796
Other Information
ProviderEnumerationDate: 01/17/2007
LastUpdateDate: 04/01/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: MEYER
AuthorizedOfficialFirstName: C.
AuthorizedOfficialMiddleName: DANA
AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 3177734482
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: O.D.
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
152W00000X18001746AINY193400000X SINGLE SPECIALTY GROUPEye and Vision Services ProvidersOptometrist 

No ID Information.


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