Rodriguez, Edwin Ivan

Rodriguez, Edwin Ivan is an individual health care provider with primary practice located at 15311 W 119Th St , Olathe KS 66062-5290. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Rodriguez, Edwin Ivan can be contacted via phone (913) 780-3200.

Contact Information

Primary practice address
15311 W 119Th St Olathe KS 66062-5290
Phone: (913) 780-3200
Fax: (913) 780-6770
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X KS-1466 Kansas

Profile Details

NPI number 1821070996
LBN Legal business name Rodriguez, Edwin Ivan
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 15th, 2005
Last updated Feb 24th, 2012 - about 13 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 1821070996 NPPES
Other 22515081 BCBS OF KC
MEDICAID 100220540B BCBS OF KC
Other 3405670 BCBS OF KC
Other 390312 BCBS OF KC
Other P00327881 BCBS OF KC

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