Clegg, Barry Andrew
Clegg, Barry Andrew is an sole proprietor health care provider with primary practice located at 2352 Poplar Dr , Medford OR 97504-5297. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Clegg, Barry Andrew can be contacted via phone (541) 772-2895.Contact Information
Primary practice address
2352 Poplar Dr
Medford OR 97504-5297
Phone: (541) 772-2895
Fax: (541) 772-0531
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2531T | Oregon |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 620 | Montana |
Profile Details
| NPI number | 1578625612 |
|---|---|
| LBN Legal business name | Clegg, Barry Andrew |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 14th, 2006 |
| Last updated | Jul 9th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1578625612 | NPPES |
| Oregon | MEDICAID | 075965 |
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