Likens, Elwood Glenn
Likens, Elwood Glenn is an individual health care provider with primary practice located at 2025 N Marine Blvd , Jacksonville NC 28546-6920. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Likens, Elwood Glenn can be contacted via phone (910) 937-1297.Contact Information
Primary practice address
2025 N Marine Blvd
Jacksonville NC 28546-6920
Phone: (910) 937-1297
Fax: (910) 937-1296
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 1550 | North Carolina |
Profile Details
| NPI number | 1558314120 |
|---|---|
| LBN Legal business name | Likens, Elwood Glenn |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 18th, 2006 |
| Last updated | Aug 11th, 2010 - about 16 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 | 1558314120 | NPPES |
| North Carolina | MEDICAID | 890903R |
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