Brodersen, Jeremy James

Brodersen, Jeremy James is an sole proprietor health care provider with primary practice located at 3539 Southern Hills Dr , Sioux City IA 51106-4750. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Brodersen, Jeremy James can be contacted via phone (712) 276-2323.

Contact Information

Primary practice address
3539 Southern Hills Dr Sioux City IA 51106-4750
Phone: (712) 276-2323
Fax: (712) 274-9986
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 2181 Iowa

Profile Details

NPI number 1477664902
LBN Legal business name Brodersen, Jeremy James
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 31st, 2006
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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1477664902 NPPES
Iowa MEDICAID 1289819

Popular Providers