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Contact Information

GREG D BOURDON, OD
5001 MONROE ST
JCPENNEY OPTICAL
TOLEDO, OH43623-3627
 Phone: 419-474-4308
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for GREG D BOURDON · (Male)

NPI # 1750424073
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 02/15/2007
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 Yes
Identifiers
  • OH License # 5198 T2102
  • OH Medicaid 2373784
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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