Dewitt, Diane C
Dewitt, Diane C is an sole proprietor health care provider with primary practice located at 1217 Pile St , Clovis NM 88101-5944. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Dewitt, Diane C can be contacted via phone (575) 763-5522.Contact Information
Primary practice address
1217 Pile St
Clovis NM 88101-5944
Phone: (575) 763-5522
Fax: (575) 763-4722
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2364 | New Mexico |
Profile Details
| NPI number | 1265412639 |
|---|---|
| LBN Legal business name | Dewitt, Diane C |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 20th, 2006 |
| Last updated | Jun 15th, 2011 - about 13 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 | 1265412639 | NPPES |
| New Mexico | MEDICAID | P1167 | |
| New Mexico | Other | NM00P427 |
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