Ellenbecker, Wayne D
Ellenbecker, Wayne D is an individual health care provider with primary practice located at 1250 W Ironwood Dr Suite 201, Coeur D Alene ID 83814-2679. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Ellenbecker, Wayne D can be contacted via phone (208) 667-2255.Contact Information
Primary practice address
1250 W Ironwood Dr Suite 201
Coeur D Alene ID 83814-2679
Phone: (208) 667-2255
Fax: (208) 765-5889
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 800 | Idaho |
Profile Details
| NPI number | 1710972450 |
|---|---|
| LBN Legal business name | Ellenbecker, Wayne D |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 19th, 2005 |
| Last updated | Sep 25th, 2017 - about 7 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 | 1710972450 | NPPES |
| Idaho | MEDICAID | 002689900 |
Popular Providers
-
Keplinger, Brian Leigh
15 Grandview Dr Ste D, Frankfort KY 40601-3235 -
Brudner, Peter N.
425 W Central Ave , Lompoc CA 93436-2805 -
Clapper, Roy Lavern
355 E Neider Ave , Coeur D Alene ID 83815-3723 -
Ellenbecker, Cindy L
1250 W Ironwood Dr , Coeur D Alene ID 83814-2679 -
Greene, Raymond Karl
850 W Ironwood Dr Suite 104, Coeur D Alene ID 83814-4903 -
Butherus, Kelsi
355 E Neider Ave , Coeur D Alene ID 83815-3723 -
Roth, Reed T
28370 Kensington Ln Suite A, Perrysburg OH 43551-4163 -
Johnson, Robert John
1801 N 3Rd St , Coeur D Alene ID 83814-3400