Burdick, Blaine Landon

Burdick, Blaine Landon is an individual health care provider with primary practice located at 211 4Th St Ne Ste 1 , Devils Lake ND 58301-2479. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Burdick, Blaine Landon can be contacted via phone (701) 662-2817.

Contact Information

Primary practice address
211 4Th St Ne Ste 1 Devils Lake ND 58301-2479
Phone: (701) 662-2817
Fax: (701) 662-2040
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 675 North Dakota

Profile Details

NPI number 1235393489
LBN Legal business name Burdick, Blaine Landon
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 17th, 2008
Last updated Apr 8th, 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 1235393489 NPPES
North Dakota Other 1235393489 ND BLUE CROSS/SHIELD
North Dakota MEDICAID 60678 ND BLUE CROSS/SHIELD
North Dakota Other 893212 ND BLUE CROSS/SHIELD

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