Bewley, James Russell
Bewley, James Russell is an individual health care provider with primary practice located at 420 E Elm Street , Caldwell ID 83605-4846. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Bewley, James Russell can be contacted via phone (208) 459-2020.Contact Information
Primary practice address
420 E Elm Street
Caldwell ID 83605-4846
Phone: (208) 459-2020
Fax: (208) 459-2034
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | ODP 100085 | Idaho |
Profile Details
| NPI number | 1639257017 |
|---|---|
| LBN Legal business name | Bewley, James Russell |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 1st, 2006 |
| Last updated | Aug 30th, 2012 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1639257017 | NPPES |
| Idaho | MEDICAID | 807263100 |
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