Walt'S Optical Shop

LBN: Charles P. Lawless, M.D., P.A.
Walt'S Optical Shop is an health care organization with primary practice located at 1777 E Clark St Ste 310 , Pocatello ID 83201-3357. The organization recently has only one registered license in Other Service Providers / Specialist, which is considered as the primary health care specialty. Charles P. Lawless, M.D., P.A. can be contacted via phone (208) 232-4133, or through Lawless, Charles Pittman via phone (208) 232-4133.

Contact Information

Primary practice address
1777 E Clark St Ste 310 Pocatello ID 83201-3357
Phone: (208) 232-4133
Fax: (208) 233-5736
Website:
Map and Directions
Authorized official contact:
Name: Lawless, Charles Pittman Doctor of Medicine (MD)
Phone: (208) 232-4133

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X M-3434 Idaho

Profile Details

NPI number 1629280359
LBN Legal business name Charles P. Lawless, M.D., P.A.
DBA Doing business as Walt'S Optical Shop
Authorized official Lawless, Charles Pittman Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date May 4th, 2007
Last updated Dec 3rd, 2007 - about 19 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629280359 NPPES
Idaho Other 000010005308 REGENCE BLUE SHIELD OF ID
Idaho Other 07302 REGENCE BLUE SHIELD OF ID

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