Bourgault, Stephen John
Bourgault, Stephen John is an individual health care provider with primary practice located at 61 Fox St , Fitchburg MA 01420-3235. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Bourgault, Stephen John can be contacted via phone (978) 342-7147.Contact Information
Primary practice address
61 Fox St
Fitchburg MA 01420-3235
Phone: (978) 342-7147
Fax: (978) 345-3567
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2887 | Massachusetts |
Profile Details
| NPI number | 1407849029 |
|---|---|
| LBN Legal business name | Bourgault, Stephen John |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 30th, 2005 |
| 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 | 1407849029 | NPPES |
| Massachusetts | MEDICAID | 9783814 |
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