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
Fax: (219) 462-3238
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518931310 NPPES
Indiana MEDICAID 100150190A
Indiana Other 000000084617
Indiana Other 180011

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