Ross, Brian Matthew

Ross, Brian Matthew is an individual health care provider with primary practice located at 643 Ohio St , Terre Haute IN 47807-3525. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Ross, Brian Matthew can be contacted via phone (812) 232-0073.

Contact Information

Primary practice address
643 Ohio St Terre Haute IN 47807-3525
Phone: (812) 232-0073
Fax: (812) 232-0074
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 18003235A Indiana

Profile Details

NPI number 1144213786
LBN Legal business name Ross, Brian Matthew
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2005
Last updated Sep 9th, 2014 - about 12 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 1144213786 NPPES
Indiana MEDICAID 200444580

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