Bourdon, Greg David
Bourdon, Greg David is an sole proprietor health care provider with primary practice located at 5001 Monroe St Jcpenney Optical, Toledo OH 43623-3627. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Bourdon, Greg David can be contacted via phone (419) 474-4308.Contact Information
Primary practice address
5001 Monroe St Jcpenney Optical
Toledo OH 43623-3627
Phone: (419) 474-4308
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 5198 T2102 | Ohio |
Profile Details
| NPI number | 1750424073 |
|---|---|
| LBN Legal business name | Bourdon, Greg David |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 15th, 2007 |
| Last updated | Jul 8th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1750424073 | NPPES |
| Ohio | MEDICAID | 2373784 |
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