Gardner, Jeremy Russell
Gardner, Jeremy Russell is an individual health care provider with primary practice located at 746 N Maize Rd Ste 100 , Wichita KS 67212-4571. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Gardner, Jeremy Russell can be contacted via phone (316) 665-7647.Contact Information
Primary practice address
746 N Maize Rd Ste 100
Wichita KS 67212-4571
Phone: (316) 665-7647
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | OPT-002433 | Arizona |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2117 | Kansas |
Profile Details
| NPI number | 1710503412 |
|---|---|
| LBN Legal business name | Gardner, Jeremy Russell |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 18th, 2020 |
| Last updated | Jul 14th, 2020 - about 6 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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