Archibald, Kent M.

Archibald, Kent M. is an individual health care provider with primary practice located at 76 Professional Plz , Rexburg ID 83440-2047. He recently has 7 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Low Vision Rehabilitation, Eye and Vision Services Providers / Pediatrics, Eye and Vision Services Providers / Sports Vision, Eye and Vision Services Providers / Vision Therapy, Eye and Vision Services Providers / Occupational Vision. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Archibald, Kent M. can be contacted via phone (208) 356-4585.

Contact Information

Primary practice address
76 Professional Plz Rexburg ID 83440-2047
Fax: (208) 356-4587
Website:

Profile Details

NPI number 1851336721
LBN Legal business name Archibald, Kent M.
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 17th, 2006
Last updated May 21st, 2008 - about 16 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 1851336721 NPPES
Idaho Other 410007525 RAIL ROAD
Idaho Other V109-4 RAIL ROAD
Idaho Other 00010015323 RAIL ROAD
Idaho Other 82-0383776 RAIL ROAD
Idaho MEDICAID 002457600 RAIL ROAD
Idaho Other ODP-513 RAIL ROAD

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