Evergreen Eye Clinic is a Optometrist Center in Lagrange, Indiana. It is situated at 201 W Wayne St, Lagrange and its contact number is 260-463-3421. The authorized person of Evergreen Eye Clinic is Dr. Ricky Lee Weidow
who is President of the clinic and their contact number is 260-463-3421. Primary license number for Evergreen Eye Clinic is 18002670A/B (Optometrist) in Indiana. Evergreen Eye Clinic Center have optometrists who can examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. Optometrists are eye health care professionals who are state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
Complete Center Profile:
Evergreen Eye Clinic Center speciality, address, contact phone number and fax are as below.
Patients can call the eye care center on the below given phone number for appointment.
Specialization:
Optometry
Clinic Address:
201 W Wayne St, Lagrange, Indiana, 46761-1850
Phone:
260-463-3421
Fax:
260-463-7347
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this clinic are as below. Person's position and contact details are also mentioned below.
Name:
Dr. Ricky Lee Weidow
Position:
President
Contact Number:
260-463-3421
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Evergreen Eye Clinic Center are as mentioned below.
NPI Number:
1174740682
NPI Enumeration Date:
19 Apr, 2007
NPI Last Update On:
27 Feb, 2010
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Evergreen Eye Clinic are as mentioned below.
Specialization
License Number
State
Status
Optometrist
18002670A/B
Indiana
Primary
Eyewear Supplier (equipment, Not The Service)
18002670A/B
Indiana
Secondary
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
2605932505
Other
Indiana
Vision Service Plan Topeka
5742334109
Other
Indiana
Vision Service Plan South Bend
200097680D
Medicaid
Indiana
2604633421
Other
Indiana
Vision Service Plan Lagrange
000000257711
Other
Indiana
Anthem Bc/bs Lagrange
000000257712
Other
Indiana
Anthem Bc/bs Topeka
000000635212
Other
Indiana
Anthem Nwielc Knox
200097680E
Medicaid
Indiana
1639177793
Other
Indiana
Ricky Weidow Npi
200097680C
Medicaid
Indiana
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
Evergreen Eye Clinic 201 W Wayne St, Po Box 150 Lagrange, Indiana
Zip:
46761-1850
Phone Number:
260-463-3421
Fax Number:
260-463-7347
Patients can reach Evergreen Eye Clinic at 201 W Wayne St, Lagrange, Indiana or can call to book an appointment on 260-463-3421. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 09 December, 2024.