Bausback, Jon

Bausback, Jon is an individual health care provider with primary practice located at 1225 E Coolspring Ave , Michigan City IN 46360-6312. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Bausback, Jon can be contacted via phone (219) 878-5021.

Contact Information

Primary practice address
1225 E Coolspring Ave Michigan City IN 46360-6312
Phone: (219) 878-5021
Fax: (219) 878-5002
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 18001410A Indiana

Profile Details

NPI number 1679543342
LBN Legal business name Bausback, Jon
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 25th, 2006
Last updated Nov 16th, 2011 - about 13 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1679543342 NPPES
Indiana MEDICAID 200112890

Popular Providers