Ebersole, Stephen Lewis

Ebersole, Stephen Lewis is an individual health care provider with primary practice located at 168 East Ave Optometric Associates, Lewiston ME 04240. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Ebersole, Stephen Lewis can be contacted via phone (207) 784-3564.

Contact Information

Primary practice address
168 East Ave Optometric Associates Lewiston ME 04240
Phone: (207) 784-3564
Fax: (207) 782-2541
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 832TA Maine
Eye and Vision Services Providers / Optometrist 152W00000X OPT832TA6 Maine

Profile Details

NPI number 1235174889
LBN Legal business name Ebersole, Stephen Lewis
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 18th, 2006
Last updated Jan 4th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235174889 NPPES
Maine MEDICAID 313250099

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