Blodgett, William Randolph
Blodgett, William Randolph is an individual health care provider with primary practice located at 500 Mill St Suite A-1, Danville PA 17821-1015. He recently has 2 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 / Corneal and Contact Management is his primary health care specialty. Blodgett, William Randolph can be contacted via phone (570) 275-0901.Contact Information
Primary practice address
500 Mill St Suite A-1
Danville PA 17821-1015
Phone: (570) 275-0901
Fax: (570) 275-0901
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | OEG001014 | Pennsylvania |
| Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | OEG001014 | Pennsylvania |
Profile Details
| NPI number | 1043376676 |
|---|---|
| LBN Legal business name | Blodgett, William Randolph |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 28th, 2006 |
| Last updated | Apr 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1043376676 | NPPES |
| Pennsylvania | Other | BL750828 | BLUE SHIELD |
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