Cloninger, Fred S
Cloninger, Fred S is an sole proprietor health care provider with primary practice located at 406 S Broad St Suite A, Gastonia NC 28054-4304. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Cloninger, Fred S can be contacted via phone (704) 865-3731.Contact Information
Primary practice address
406 S Broad St Suite A
Gastonia NC 28054-4304
Phone: (704) 865-3731
Fax: (704) 864-5736
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 804 | North Carolina |
Profile Details
| NPI number | 1508965161 |
|---|---|
| LBN Legal business name | Cloninger, Fred S |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 21st, 2006 |
| Last updated | Oct 2nd, 2008 - 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 | 1508965161 | NPPES |
| North Carolina | Other | 410009765 | RAILROAD MEDICARE |
| North Carolina | MEDICAID | 8909163 | RAILROAD MEDICARE |
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