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
Phone: (208) 459-2020
Fax: (208) 459-2034
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063591162 | NPPES |
| Idaho | MEDICAID | 002752500 |
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