| NPI Number |
1841286176 |
| Credentials |
OD
(Doctor of Optometry)
|
| Entity |
Individual
|
| Enumeration date |
09/22/2005 |
| Last updated |
10/27/2008 - About 18 years ago
|
| Sole proprietor1 |
Yes
|
| Identifiers |
- CA License #: 6938
- IA License #: 1709
- IA Medicaid: 0005314
- Other: 421168561 AARP
- Other: 421168561 ACCOUNTABLE HEALTH
- Other: 421168561 ADVANTICA EYECARE
- Other: 421168561 ADVANTRA FREEDOM
- Other: 421168561 AMERICAN REPUBLIC
- Other: 421168561 AMERICARE
- Other: 421168561 AUTO OWNERS, PRAIRIE STATES
- Other: 421168561 BANKERS LIFE
- Other: 421168561 BRIDGESTONE/FIRESTONE
- Other: 6938 CALIFORNIA LICENSE
- Other: 421168561 CENTRAL RESERVE
- Other: 81376 COVENTRY ADVANTRA
- Other: 81376 COVENTRY HEALTHCARE
- Other: 421168561 DEFINITY HEALTH
- Other: 421168561 EBC (EMPLOYEE BENEFIT CONSULTANTS)
- Other: 421168561 EVERCARE
- Other: 421168561 FEDERATED INSURANCE
- Other: 17996 FIRST ADMINISTRATORS
- Other: 421168561 GLACERS LOCAL #558
- Other: 421168561 GUARANTEE TRUST LIFE INS. CO.
- Other: 421168561 HUMANA
- Other: 1709 IOWA LICENSE
- Other: 421168561 MAILHANDLERS
- Other: 421168561 MED BEN
- Other: 421168561 MEDICARE COMPLETE
- Other: 752838447 MIDLANDS CHOICE
- Other: 17996 MUTUAL OF OMAHA
- Other: 421168561 PIRELLI ARMSTRONG
- Other: 421168561 PRINCIPAL HEALTHCARE
- Other: 410020694 RAILROAD MEDICARE
- Other: 421168561 SECUREHORIZONS
- Other: 421168561 SOUTHERN BENEFIT ADMINISTRATORS INC
- Other: 421168561 TODAY'S OPTIONS
- Other: 0000 TRIWEST
- Other: 421168561 UNICARE
- Other: 421168561 UNITED AMERICAN INSURANCE COMPANY
- Other: 421168561 UNITED HEALTHCARE
- Other: IA0101 UNITED HEALTHCARE OF THE RIVER VALLEY
- Other: 17996 WELLMARK BLUE SHIELD
|
| 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.