Bigelow, Paul
Bigelow, Paul is an individual health care provider with primary practice located at 230 W Mallard Dr Ste A , Boise ID 83706-3995. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Bigelow, Paul can be contacted via phone (208) 342-4841.Contact Information
Primary practice address
230 W Mallard Dr Ste A
Boise ID 83706-3995
Phone: (208) 342-4841
Fax: (208) 343-9553
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | ODP-577 | Idaho |
Profile Details
| NPI number | 1811993512 |
|---|---|
| LBN Legal business name | Bigelow, Paul |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 27th, 2005 |
| Last updated | Dec 17th, 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 | 1811993512 | NPPES |
| Idaho | MEDICAID | 0026587 | |
| Idaho | Other | P00419679 |
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