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
Phone: (616) 866-0140
Fax: (616) 866-8694
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1427020023 | NPPES |
| Other | 1780888081 | GROUP NPI | |
| Other | 1427020023 | GROUP NPI | |
| MEDICAID | 5106316 | GROUP NPI |
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