Eggebrecht, Susan Lynn
Eggebrecht, Susan Lynn is an individual health care provider with primary practice located at 7750 W Jefferson Blvd , Fort Wayne IN 46804. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Eggebrecht, Susan Lynn can be contacted via phone (260) 459-9595.Contact Information
Primary practice address
7750 W Jefferson Blvd
Fort Wayne IN 46804
Phone: (260) 459-9595
Fax: (260) 459-9494
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 18002378A | Indiana |
Profile Details
| NPI number | 1700857281 |
|---|---|
| LBN Legal business name | Eggebrecht, Susan Lynn |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 31st, 2006 |
| Last updated | Mar 13th, 2014 - about 10 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 | 1700857281 | NPPES |
| Indiana | MEDICAID | 100464730 |
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