Provider Demographics
NPI:1871628347
Name:LANTER EYECARE & LASER SURGERY PC
Entity type:Organization
Organization Name:LANTER EYECARE & LASER SURGERY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EARL
Authorized Official - Middle Name:E
Authorized Official - Last Name:LANTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD, OD
Authorized Official - Phone:317-844-6269
Mailing Address - Street 1:10610 N PENNSYLVANIA ST
Mailing Address - Street 2:STE B
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46280-2000
Mailing Address - Country:US
Mailing Address - Phone:317-844-6269
Mailing Address - Fax:317-815-7567
Practice Address - Street 1:747 E COUNTY LINE RD
Practice Address - Street 2:STE M
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46143-1050
Practice Address - Country:US
Practice Address - Phone:317-844-6269
Practice Address - Fax:317-815-7567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN0111609909207W00000X, 332H00000X
IN0004923421332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
No332H00000XSuppliersEyewear Supplier