NPI 1043614027

Fountain Square Eye Care

Organisation Optometrist Indianapolis, IN

Practice location

Address: 1429 Shelby St, Indianapolis, IN 46203-1946
Phone: (317) 632-9220

Authorised official

Name: Rajender Macha
Title: President/Owner
Phone: (765) 649-1200

Registered specialties

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X Licence 18002944A (IN)

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Registry record

NPI: 1043614027
Entity type: Organization
NPI issued: 20 Oct 2014
Record last updated: 20 Oct 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.