Michiana Eye Center LLC

NPI #1073671731 in South Bend, Indiana

Provider Information

NPI Number: 1073671731
Entity Type: Organization
Organization Name: Michiana Eye Center LLC
Primary Specialty: Ophthalmology
Enumeration Date: Dec 5, 2006
Last Updated: Jun 18, 2018

Practice Location

Address: 319 N NILES AVE # 100
City: South Bend
State: Indiana
ZIP Code: 46617
Phone: (574) 282-2020

Authorized Official

Name: KEVIN R BAXTER, DO
Title: OWNER/OPHTHALMOLOGIST
Phone: (574) 271-3939

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Plastic Surgery - Plastic Surgery Within the Head and Neck — Plastic Surgery Within the Head and Neck	2082S0099X
Durable Medical Equipment & Medical Supplies	332B00000X
Optometrist	152W00000X
Specialist	174400000X
Ophthalmology	207W00000X	Primary

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