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
Fax: (920) 499-9215
Website:

Health care specialties

SpecialtyCodeLicense #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 18 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 1265484042 NPPES
Wisconsin MEDICAID 38504800

Popular Providers