Thomas, Jamie

Thomas, Jamie is an individual health care provider with primary practice located at 1155 Pocatello Creek Rd , Pocatello ID 83201-2949. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Thomas, Jamie can be contacted via phone (208) 233-2020.

Contact Information

Primary practice address
1155 Pocatello Creek Rd Pocatello ID 83201-2949
Phone: (208) 233-2020
Fax: (208) 233-2021
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X ODP100029 Idaho

Profile Details

NPI number 1124014295
LBN Legal business name Thomas, Jamie
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 23rd, 2005
Last updated Apr 13th, 2011 - about 14 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 1124014295 NPPES
Idaho MEDICAID 002446900

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