Mcgourty, Brian J.
Mcgourty, Brian J. is an individual health care provider with primary practice located at 310 2Nd St S , Nampa ID 83651-3765. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Mcgourty, Brian J. can be contacted via phone (208) 467-1361.Contact Information
Primary practice address
310 2Nd St S
Nampa ID 83651-3765
Phone: (208) 467-1361
Fax: (208) 467-9008
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 0-592 | Idaho |
Profile Details
| NPI number | 1811091309 |
|---|---|
| LBN Legal business name | Mcgourty, Brian J. |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 12th, 2006 |
| Last updated | Jun 28th, 2010 - about 15 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 | 1811091309 | NPPES |
| Idaho | MEDICAID | 002622300 | |
| Idaho | Other | 000010015424 | |
| Idaho | Other | E00820496865 | |
| Idaho | Other | 82049686583651A001 | |
| Idaho | Other | V9063 |
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