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Contact Information

GREGORY C LANDIS, OD
3201 5TH ST
LEWISTON, ID83501
 Phone: 208-743-2020
 Fax: 087-433-5832
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for GREGORY C LANDIS · (Male)

NPI Number 1447253885
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 05/31/2005
Last updated 05/23/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • ID License # ODP-100426
  • OH License # 3948/T1027
  • OH Medicaid 0729082
  • OH Other 5886015 AETNA
  • OH Other 000000117385 ANTHEM BC/BS
  • OH Other 2201051 UHC
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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