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
Phone: (812) 945-0023
Fax: (812) 945-0291
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1669486866 | NPPES |
| Indiana | MEDICAID | 300012451 |
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