Provider Demographics
NPI:1669558862
Name:INSIGHT EYECARE ASSOCIATES INC
Entity type:Organization
Organization Name:INSIGHT EYECARE ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:L
Authorized Official - Last Name:MASDEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:812-366-3147
Mailing Address - Street 1:8010 OAK PARK RD NE
Mailing Address - Street 2:PO BOX 69
Mailing Address - City:NEW SALISBURY
Mailing Address - State:IN
Mailing Address - Zip Code:47161
Mailing Address - Country:US
Mailing Address - Phone:812-366-3147
Mailing Address - Fax:812-366-3451
Practice Address - Street 1:8010 OAK PARK RD NE
Practice Address - Street 2:
Practice Address - City:NEW SALISBURY
Practice Address - State:IN
Practice Address - Zip Code:47161
Practice Address - Country:US
Practice Address - Phone:812-366-3147
Practice Address - Fax:812-366-3451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200337130AMedicaid
INCH9863OtherMEDICARE RAILROAD
IN254430Medicare PIN
IN0300710001Medicare NSC
IN200337130AMedicaid