Stadick, John H

Stadick, John H is an individual health care provider with primary practice located at 1700 Cerrillos Rd , Santa Fe NM 87505-3554. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Stadick, John H can be contacted via phone (505) 988-9821.

Contact Information

Primary practice address
1700 Cerrillos Rd Santa Fe NM 87505-3554
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 992 Arizona

Profile Details

NPI number 1689651978
LBN Legal business name Stadick, John H
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 28th, 2005
Last updated Oct 24th, 2007 - about 19 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 1689651978 NPPES
New Mexico MEDICAID A6452

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