Bolluyt, Jeremy E

Bolluyt, Jeremy E is an individual health care provider with primary practice located at 2700 23Rd St Suite C, Spirit Lake IA 51360-1158. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Bolluyt, Jeremy E can be contacted via phone (712) 336-3750.

Contact Information

Primary practice address
2700 23Rd St Suite C Spirit Lake IA 51360-1158
Phone: (712) 336-3750
Fax: (712) 336-3730
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 3326 Iowa

Profile Details

NPI number 1760452205
LBN Legal business name Bolluyt, Jeremy E
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 26th, 2006
Last updated Nov 6th, 2007 - about 17 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 1760452205 NPPES
Iowa MEDICAID 1187948

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