Long, Jilda Edean

Long, Jilda Edean is an sole proprietor health care provider with primary practice located at 22 Campbell Ave Se , Roanoke VA 24011. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Long, Jilda Edean can be contacted via phone (540) 982-7890.

Contact Information

Primary practice address
22 Campbell Ave Se Roanoke VA 24011
Phone: (540) 982-7890
Fax: (540) 982-7891
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 0618001106 Virginia

Profile Details

NPI number 1568405884
LBN Legal business name Long, Jilda Edean
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 14th, 2006
Last updated Aug 2nd, 2019 - about 7 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 1568405884 NPPES
Virginia MEDICAID 9237674
Virginia Other 542036583
Virginia Other 277658
Virginia Other 2119121

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