Jangula, Jesse James

Jangula, Jesse James is an individual health care provider with primary practice located at 185 W 4Th Ave Suite A, Post Falls ID 83854-4978. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Jangula, Jesse James can be contacted via phone (208) 773-7434.

Contact Information

Primary practice address
185 W 4Th Ave Suite A Post Falls ID 83854-4978
Phone: (208) 773-7434
Fax: (208) 777-0836
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 60099363 Washington
Eye and Vision Services Providers / Optometrist 152W00000X ODP-100218 Idaho

Profile Details

NPI number 1942534235
LBN Legal business name Jangula, Jesse James
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2009
Last updated Sep 23rd, 2013 - about 12 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 1942534235 NPPES
Idaho MEDICAID 1942534235

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