Boehme, Jacob Andrew

Boehme, Jacob Andrew is an individual health care provider with primary practice located at 1245 Madison Ave , Memphis TN 38104-2211. He recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Pediatrics, Eye and Vision Services Providers / Optometrist. Eye and Vision Services Providers / Pediatrics is his primary health care specialty. Boehme, Jacob Andrew can be contacted via phone (901) 722-3200.

Contact Information

Primary practice address
1245 Madison Ave Memphis TN 38104-2211
Phone: (901) 722-3200
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Pediatrics 152WP0200X 3656 Tennessee
Eye and Vision Services Providers / Optometrist 152W00000X 3656 Tennessee

Profile Details

NPI number 1942801907
LBN Legal business name Boehme, Jacob Andrew
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 5th, 2020
Last updated Mar 26th, 2021 - about 5 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 1942801907 NPPES
Tennessee MEDICAID Q063630

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