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
Fax: (208) 467-9008
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811091309 NPPES
Idaho MEDICAID 002622300
Idaho Other 000010015424
Idaho Other E00820496865
Idaho Other 82049686583651A001
Idaho Other V9063

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