Blackman, Stanley Neil
Blackman, Stanley Neil is an sole proprietor health care provider with primary practice located at 2009 Roosevelt Rd Suite D, Valparaiso IN 46383-3765. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Blackman, Stanley Neil can be contacted via phone (219) 462-5501.Contact Information
Primary practice address
2009 Roosevelt Rd Suite D
Valparaiso IN 46383-3765
Phone: (219) 462-5501
Fax: (219) 462-3238
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 18001528B | Indiana |
Profile Details
| NPI number | 1518931310 |
|---|---|
| LBN Legal business name | Blackman, Stanley Neil |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 16th, 2006 |
| Last updated | Dec 2nd, 2010 - about 16 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 | 1518931310 | NPPES |
| Indiana | MEDICAID | 100150190A | |
| Indiana | Other | 000000084617 | |
| Indiana | Other | 180011 |
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