Vidlak, Daniel Joseph

Vidlak, Daniel Joseph is an individual health care provider with primary practice located at 1022 Nw 6Th Street , Grants Pass OR 97526. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Vidlak, Daniel Joseph can be contacted via phone (541) 476-4545.

Contact Information

Primary practice address
1022 Nw 6Th Street Grants Pass OR 97526
Phone: (541) 476-4545
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 2643ATI Oregon

Profile Details

NPI number 1477648772
LBN Legal business name Vidlak, Daniel Joseph
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 3rd, 2006
Last updated Mar 7th, 2023 - about 3 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 1477648772 NPPES
Oregon MEDICAID 150462
Oregon Other 2643ATI

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