Devries, Gerrit H.
Devries, Gerrit H. is an individual health care provider with primary practice located at 609 N Halleck St , Demotte IN 46310-9545. He recently has 4 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Occupational Vision, Eye and Vision Services Providers / Pediatrics. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Devries, Gerrit H. can be contacted via phone (219) 987-3673.Contact Information
Primary practice address
609 N Halleck St
Demotte IN 46310-9545
Phone: (219) 987-3673
Fax: (219) 987-3905
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 18001809B | Indiana |
| Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | 18001809B | Indiana |
| Eye and Vision Services Providers / Occupational Vision | 152WX0102X | 18001809B | Indiana |
| Eye and Vision Services Providers / Pediatrics | 152WP0200X | 18001809B | Indiana |
Profile Details
| NPI number | 1992729206 |
|---|---|
| LBN Legal business name | Devries, Gerrit H. |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 27th, 2006 |
| Last updated | Sep 2nd, 2010 - about 14 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 | 1992729206 | NPPES |
| Indiana | MEDICAID | 100142770A |
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