Heitzman, Jon E

Heitzman, Jon E is an individual health care provider with primary practice located at 2680 S Lincoln Ave , Jerome ID 83338-6128. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Heitzman, Jon E can be contacted via phone (208) 324-4333.

Contact Information

Primary practice address
2680 S Lincoln Ave Jerome ID 83338-6128
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X ODP-495 Idaho

Profile Details

NPI number 1194838375
LBN Legal business name Heitzman, Jon E
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 15th, 2006
Last updated Jul 9th, 2007 - about 19 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 1194838375 NPPES
Idaho MEDICAID 8041644

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