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Contact Information

GARY T COBURN, OD
725 N LINCOLN ROAD
ROCKVILLE, IN47872
 Phone: 765-569-2008
 Fax: 765-569-2009
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for GARY T COBURN · (Male)

NPI Number 1184771834
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 01/04/2007
Last updated 03/20/2012 - About 14 years ago
Sole proprietor 1 Yes
Identifiers
  • IN License # 18001654
  • IN Medicaid 200954600
  • IN Other 000000264646 ANTHEM
  • IN Other 000000264522 ANTHEM PIN
  • IN Other 410046751 RAILROAD MEDICARE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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