Dostall, Timothy Robert

Dostall, Timothy Robert is an sole proprietor health care provider with primary practice located at 411 East Ave , Elyria OH 44035. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Dostall, Timothy Robert can be contacted via phone (440) 323-5709.

Contact Information

Primary practice address
411 East Ave Elyria OH 44035
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 3387T414 Ohio

Profile Details

NPI number 1659343432
LBN Legal business name Dostall, Timothy Robert
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 6th, 2006
Last updated Mar 21st, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659343432 NPPES
Ohio MEDICAID 0462495

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