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A&K KOUKLAKIS OD P.C. NPI 1295858371


NPI Information

NPI: 1295858371
Provider Name: A&K KOUKLAKIS OD P.C.

Doing Business As: VISION QUEST EYE CLINICS

Classification: Eyewear Supplier - 332H00000X
Entity Type: Organization
Address:
521 BROADWAY
GARY, IN
ZIP 46402
Phone: (219) 882-9397
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A&K KOUKLAKIS OD P.C. is an eyewear supplier in Gary, IN. The provider is an organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. A&K KOUKLAKIS OD P.C. NPI is 1295858371. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Vision Quest Eye Clinics.

The provider's business location address is:

521 BROADWAY
GARY, IN
ZIP 46402-910
Phone: (219) 882-9397
Fax: (219) 882-9649

The provider's authorized official is Alexander Haridimos Kouklakis .
The authorized official title is President and has the following contact phone number (219) 756-1700.

The enumeration date for this NPI number is 4/6/2007 and was last updated on 11/5/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1152W00000XOptometristNo
2332H00000XEyewear SupplierYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1100215150CMEDICAIDINDIANA
2708660MEDICARE ID-TYPE UNSPECIFIEDINDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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