Burgett, Jason M

Burgett, Jason M is an individual health care provider with primary practice located at 1345 Unity Pl Suite 245, Lafayette IN 47905-5770. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Burgett, Jason M can be contacted via phone (765) 446-5130.

Contact Information

Primary practice address
1345 Unity Pl Suite 245 Lafayette IN 47905-5770
Phone: (765) 446-5130
Fax: (765) 446-5131
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 01046886A Indiana

Profile Details

NPI number 1023061736
LBN Legal business name Burgett, Jason M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 17th, 2006
Last updated Jun 15th, 2020 - about 4 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 1023061736 NPPES
Indiana Other 180043005 RAILROAD MEDICARE
Indiana MEDICAID 200133220 RAILROAD MEDICARE

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