Kent M Archibald P.A.

LBN: Kent M Archibald P.A.
Kent M Archibald P.A. is an health care organization with primary practice located at 76 Professional Plz , Rexburg ID 83440-2047. The organization recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as the primary health care specialty. Kent M Archibald P.A. can be contacted via phone (208) 356-4585, or through Archibald, Kent M via phone (208) 356-4585.

Contact Information

Primary practice address
76 Professional Plz Rexburg ID 83440-2047
Fax: (208) 356-4587
Website:
Authorized official contact:
Name: Archibald, Kent M Doctor of Optometry (OD)

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X OPD-513 Idaho

Profile Details

NPI number 1447579123
LBN Legal business name Kent M Archibald P.A.
DBA Doing business as
Authorized official Archibald, Kent M Doctor of Optometry (OD)
Entity Organization
Organization subpart 1 No
Enumeration date May 20th, 2010
Last updated Jun 20th, 2018 - about 7 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447579123 NPPES
Idaho Other ODP-513 IDAHO OPTOMETRY LICENSE
Idaho Other V109-4 IDAHO OPTOMETRY LICENSE
Idaho Other 00010015323 IDAHO OPTOMETRY LICENSE
Idaho MEDICAID 002457600 IDAHO OPTOMETRY LICENSE
Idaho Other 410007525 IDAHO OPTOMETRY LICENSE

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