Provider Demographics
NPI:1265574313
Name:ANDERSON, CLAUDE (OD)
Entity type:Individual
Prefix:
First Name:CLAUDE
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4150 LAFAYETTE RD
Mailing Address - Street 2:C
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46254-5443
Mailing Address - Country:US
Mailing Address - Phone:317-280-0114
Mailing Address - Fax:317-280-0117
Practice Address - Street 1:4150 LAFAYETTE RD
Practice Address - Street 2:C
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46254-5443
Practice Address - Country:US
Practice Address - Phone:317-280-0114
Practice Address - Fax:317-280-0117
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18002946B152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist