Fagert, Gregory J

Fagert, Gregory J is an sole proprietor health care provider with primary practice located at 14 N Main St , Columbiana OH 44408-1347. He recently has 3 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Low Vision Rehabilitation. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Fagert, Gregory J can be contacted via phone (330) 482-4124.

Contact Information

Primary practice address
14 N Main St Columbiana OH 44408-1347
Phone: (330) 482-4124
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 4099/T050 Ohio
Eye and Vision Services Providers / Corneal and Contact Management 152WC0802X 4099/T050 Ohio
Eye and Vision Services Providers / Low Vision Rehabilitation 152WL0500X 4099/T050 Ohio

Profile Details

NPI number 1366521726
LBN Legal business name Fagert, Gregory J
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 4th, 2006
Last updated Jul 22nd, 2011 - about 15 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 1366521726 NPPES
Ohio MEDICAID 976574

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