Mortensen, David D
Mortensen, David D is an sole proprietor health care provider with primary practice located at 1184 N. Main St , Crown Point IN 46307. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Mortensen, David D can be contacted via phone (219) 226-9571.Contact Information
Primary practice address
1184 N. Main St
Crown Point IN 46307
Phone: (219) 226-9571
Fax: (219) 226-9547
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 0601800582 | Virginia |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 18003429 A & B | Indiana |
Profile Details
| NPI number | 1871590430 |
|---|---|
| LBN Legal business name | Mortensen, David D |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 28th, 2005 |
| Last updated | Jul 8th, 2007 - about 18 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 | 1871590430 | NPPES |
| Virginia | Other | P00190241 | PALMETTO RAILROAD MEDICAR |
| Virginia | Other | 162686 | PALMETTO RAILROAD MEDICAR |
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