National Provider Identifier Database

JERRY P WILL SR, DISPENSING OPTICIAN – NPI #1861616955
Optician


Contact Information

JERRY P WILL SR, DISPENSING OPTICIAN
15 B COLLEGE HIGHWAY
15 B SOUTHAMPTON OPTICAL
SOUTHAMPTON, MA01073
Phone: 413-527-5613
Fax: 413-527-3526
Website:
Specialty Taxonomy Code
* Optician 156FX1800X

* Indicates primary specialty

NPI Profile & details for JERRY P WILL SR

NPI Number 1861616955
Credentials DISPENSING OPTICIAN
Entity Individual
Enumeration date 04/12/2007
Last updated 07/08/2007 - About 19 years ago
Sole proprietor1 No
Identifiers
  • MA License #: MA4110
  • MA Medicaid: 0313033
Hospital affiliation n/a

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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