Jerry Dale Warthman O.D.

NPI 1063493906 - Optometrist - 152W00000X

NPI Details
NPI 1063493906
Gender Male
Enumeration Date 11/08/2005
Last Updated 04/28/2010
Entity Type Individual
Active Over 11 years ago
Practice Location
1923 W 53RD ST
ANDERSON IN, 46013-1109, US
Phone (765) 644-0060
Fax (765) 644-0076
Business Location
1923 W 53RD ST
ANDERSON IN, 46013-1109, US
Phone (765) 644-0060
Fax (765) 644-0076
Toxanomy
Taxonomy Code 152W00000X
License State Indiana
License Number 18002286 A
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According to our database, Dr. Jerry Dale Warthman O.D. NPI is 1063493906, taxonomy code is 152W00000X and license number is 18002286 A, license state is located at Indiana. Jerry Dale Warthman O.D. physically located at 1923 W 53rd St, Anderson IN, 46013-1109. NPI Number Jerry Dale Warthman O.D. has the Individual type.

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1063493906 NPI number is provided on an as is basis without warranty of any kind. 1063493906 is maintained by the National Plan & Provider Enumeration System. The contents of Jerry Dale Warthman O.D. are for informational purposes only.