Burris, Eric Paul
Burris, Eric Paul is an individual health care provider with primary practice located at 715 Main St , Tell City IN 47586-1705. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Burris, Eric Paul can be contacted via phone (812) 547-3396.Contact Information
Primary practice address
715 Main St
Tell City IN 47586-1705
Phone: (812) 547-3396
Fax: (812) 547-5272
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 18002159B | Indiana |
Profile Details
| NPI number | 1104964592 |
|---|---|
| LBN Legal business name | Burris, Eric Paul |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 1st, 2007 |
| Last updated | May 11th, 2012 - about 12 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 | 1104964592 | NPPES |
| Indiana | MEDICAID | 100203190A | |
| Indiana | Other | 1285910001 |
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