Hagberg, Landon Knight
Hagberg, Landon Knight is an sole proprietor health care provider with primary practice located at 10876 Mud Springs Ave. , Nampa ID 83687-8013. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Hagberg, Landon Knight can be contacted via phone (208) 757-2289.Contact Information
Primary practice address
10876 Mud Springs Ave.
Nampa ID 83687-8013
Phone: (208) 757-2289
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 100220 | Idaho |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 5947 | Ohio |
Profile Details
| NPI number | 1699087437 |
|---|---|
| LBN Legal business name | Hagberg, Landon Knight |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 9th, 2010 |
| Last updated | Aug 20th, 2013 - about 13 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 | 1699087437 | NPPES |
| Idaho | MEDICAID | 1699087437 |
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