Cornett, Jamie Dale

Cornett, Jamie Dale is an individual health care provider with primary practice located at 42D Medical Group 300 S. Twining St. Bldg. 760, Maxwell Afb AL 36113. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Cornett, Jamie Dale can be contacted via phone (334) 953-3368.

Contact Information

Primary practice address
42D Medical Group 300 S. Twining St. Bldg. 760 Maxwell Afb AL 36113
Phone: (334) 953-3368
Fax: (334) 953-8607
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 1679 Kansas
Eye and Vision Services Providers / Optometrist 152W00000X 18003253A Indiana

Profile Details

NPI number 1164482956
LBN Legal business name Cornett, Jamie Dale
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 24th, 2006
Last updated Jul 26th, 2021 - about 5 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1164482956 NPPES
Kansas Other 1679 OPTOMETRY LICENSE
Kansas Other 18003253A OPTOMETRY LICENSE

Popular Providers