Optometric Associates of South Bend

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

OPTOMETRIC ASSOCIATES OF SOUTH BEND

Practice address

1001 S Edgewood Dr
#5
Knox, IN 46534-8269

Phone

(574) 772-2012

Fax

(574) 772-2221

NPI assigned

Nov 10, 2006

Last updated

Jan 3, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Thomas D. Morlan, OD

Title

Owner

Phone

(574) 772-2012

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199318400000",
    "number": "1205907540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 S EDGEWOOD DR",
            "address_2": "#5",
            "city": "KNOX",
            "state": "IN",
            "postal_code": "465348269",
            "telephone_number": "574-772-2012",
            "fax_number": "574-772-2221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 S EDGEWOOD DR",
            "address_2": "#5",
            "city": "KNOX",
            "state": "IN",
            "postal_code": "465348269",
            "telephone_number": "574-772-2012",
            "fax_number": "574-772-2221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTOMETRIC ASSOCIATES OF SOUTH BEND",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-10",
        "last_updated": "2008-01-03",
        "status": "A",
        "authorized_official_last_name": "MORLAN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "574-772-2012",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Knox, IN
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• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.