Champion-Martin, Jean M.

Champion-Martin, Jean M. is an sole proprietor health care provider with primary practice located at 332 Long Pointe Ln , Columbia SC 29229-7569. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Champion-Martin, Jean M. can be contacted via phone (803) 419-8907.

Contact Information

Primary practice address
332 Long Pointe Ln Columbia SC 29229-7569
Phone: (803) 419-8907
Fax: (803) 419-8908
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 1117 South Carolina

Profile Details

NPI number 1821163171
LBN Legal business name Champion-Martin, Jean M.
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 22nd, 2006
Last updated Jul 8th, 2007 - about 19 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 1821163171 NPPES
South Carolina MEDICAID D11173

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