Fowle, Gary J

Fowle, Gary J is an sole proprietor health care provider with primary practice located at 120 Marcell Dr Ne Suite A, Rockford MI 49341-1362. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Fowle, Gary J can be contacted via phone (616) 866-0140.

Contact Information

Primary practice address
120 Marcell Dr Ne Suite A Rockford MI 49341-1362
Fax: (616) 866-8694
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 4901002906 Michigan

Profile Details

NPI number 1427020023
LBN Legal business name Fowle, Gary J
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 7th, 2006
Last updated Sep 26th, 2016 - about 10 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 1427020023 NPPES
Other 1780888081 GROUP NPI
Other 1427020023 GROUP NPI
MEDICAID 5106316 GROUP NPI

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