Odle, Sam William

Odle, Sam William is an individual health care provider with primary practice located at 3012 Anderson Ave , Manhattan KS 66503-2809. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Odle, Sam William can be contacted via phone (785) 537-1118.

Contact Information

Primary practice address
3012 Anderson Ave Manhattan KS 66503-2809
Phone: (785) 537-1118
Fax: (785) 537-8005
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X KS-1199-2 Kansas

Profile Details

NPI number 1053392936
LBN Legal business name Odle, Sam William
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 8th, 2005
Last updated Jun 25th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053392936 NPPES
Kansas Other 005036 BCBS
Kansas MEDICAID 100218020A BCBS
Kansas Other 059825 BCBS
Kansas Other 410038216 BCBS
Kansas Other 410034609 BCBS

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