Braaten, Marcus Richard

Braaten, Marcus Richard is an individual health care provider with primary practice located at 4326 Charlestown Rd # 2 , New Albany IN 47150-8542. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Braaten, Marcus Richard can be contacted via phone (812) 945-0023.

Contact Information

Primary practice address
4326 Charlestown Rd # 2 New Albany IN 47150-8542
Fax: (812) 945-0291
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 18003432A Indiana

Profile Details

NPI number 1669486866
LBN Legal business name Braaten, Marcus Richard
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 27th, 2006
Last updated Jul 29th, 2019 - 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 1669486866 NPPES
Indiana MEDICAID 300012451

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