Birch, Jared Edgar
Birch, Jared Edgar is an individual health care provider with primary practice located at 1689 Pancheri Dr , Idaho Falls ID 83402-3041. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Birch, Jared Edgar can be contacted via phone (208) 529-4333.Contact Information
Primary practice address
1689 Pancheri Dr
Idaho Falls ID 83402-3041
Phone: (208) 529-4333
Fax: (208) 529-4366
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | ODP-100057 | Idaho |
Profile Details
| NPI number | 1881764678 |
|---|---|
| LBN Legal business name | Birch, Jared Edgar |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 8th, 2006 |
| Last updated | Jun 15th, 2016 - about 8 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 | 1881764678 | NPPES |
| Idaho | MEDICAID | 807002500 |
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