Amundson, Jill M
Amundson, Jill M is an individual health care provider with primary practice located at 15 Lowell St , Portland ME 04102-2748. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Amundson, Jill M can be contacted via phone (207) 774-8277.Contact Information
Primary practice address
15 Lowell St
Portland ME 04102-2748
Phone: (207) 774-8277
Fax: (207) 699-5850
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | OPT843 | Maine |
Profile Details
| NPI number | 1710983861 |
|---|---|
| LBN Legal business name | Amundson, Jill M |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 23rd, 2005 |
| Last updated | Mar 16th, 2017 - about 7 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710983861 | NPPES |
| Maine | MEDICAID | 323720099 |
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