Fornes , Od, James Charles
Fornes , Od, James Charles is an individual health care provider with primary practice located at 301 Bay Park Sq , Green Bay WI 54304-5104. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Fornes , Od, James Charles can be contacted via phone (920) 499-3511.Contact Information
Primary practice address
301 Bay Park Sq
Green Bay WI 54304-5104
Phone: (920) 499-3511
Fax: (920) 499-9215
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 1465 | Wisconsin |
Profile Details
| NPI number | 1265484042 |
|---|---|
| LBN Legal business name | Fornes , Od, James Charles |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 17th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1265484042 | NPPES |
| Wisconsin | MEDICAID | 38504800 |
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