Bundy, Jonathan Robert

Bundy, Jonathan Robert is an individual health care provider with primary practice located at 726 Kensington Ave , Missoula MT 59801-5720. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Bundy, Jonathan Robert can be contacted via phone (406) 549-9413.

Contact Information

Primary practice address
726 Kensington Ave Missoula MT 59801-5720
Phone: (406) 549-9413
Fax: (406) 543-4410
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X S-B55-TA-765 Alabama
Eye and Vision Services Providers / Optometrist 152W00000X 1607 Arizona
Eye and Vision Services Providers / Optometrist 152W00000X 4917 Montana

Profile Details

NPI number 1265641203
LBN Legal business name Bundy, Jonathan Robert
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 22nd, 2007
Last updated Dec 26th, 2023 - about 3 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 1265641203 NPPES
Arizona MEDICAID 331797

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