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
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1699087437 NPPES
Idaho MEDICAID 1699087437

Popular Providers