Bruce, Diane
Bruce, Diane is an individual health care provider with primary practice located at 198 Sw Broad St , Jesup GA 31545-1101. She recently has only one registered license in Eye and Vision Services Providers / Corneal and Contact Management, which is considered as her primary health care specialty. Bruce, Diane can be contacted via phone (912) 530-6000.Contact Information
Primary practice address
198 Sw Broad St
Jesup GA 31545-1101
Phone: (912) 530-6000
Fax: (912) 530-6044
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | OPT001278 | Georgia |
Profile Details
| NPI number | 1114060308 |
|---|---|
| LBN Legal business name | Bruce, Diane |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 15th, 2007 |
| Last updated | Aug 10th, 2010 - about 15 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 | 1114060308 | NPPES |
| Georgia | MEDICAID | 814827714E |
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