Black, William Thomas

Black, William Thomas is an sole proprietor health care provider with primary practice located at 420 E Elm St , 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. Black, William Thomas can be contacted via phone (208) 459-2020.

Contact Information

Primary practice address
420 E Elm St Caldwell ID 83605-4846
Fax: (208) 459-2034
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X ID0857 Idaho

Profile Details

NPI number 1063591162
LBN Legal business name Black, William Thomas
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 2nd, 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1063591162 NPPES
Idaho MEDICAID 002752500

Popular Providers