Provider Demographics
NPI:1164493011
Name:STRANSKY, THEODORE JERE (MD)
Entity type:Individual
Prefix:DR
First Name:THEODORE
Middle Name:JERE
Last Name:STRANSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10111 POWERS DR
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:IN
Mailing Address - Zip Code:47630-9213
Mailing Address - Country:US
Mailing Address - Phone:812-853-6889
Mailing Address - Fax:
Practice Address - Street 1:350 W COLUMBIA ST
Practice Address - Street 2:SUITE 250
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47710-1782
Practice Address - Country:US
Practice Address - Phone:812-423-3161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-30
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01027485207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100242110Medicaid
IL0380671080Medicaid
KY64751688Medicaid
IL0380671080Medicaid
KY64751688Medicaid