Forche, Jon L
Forche, Jon L is an individual health care provider with primary practice located at 698 S Milledge Ave , Athens GA 30605-1251. He recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Forche, Jon L can be contacted via phone (706) 543-2020.Contact Information
Primary practice address
698 S Milledge Ave
Athens GA 30605-1251
Phone: (706) 543-2020
Fax: (706) 549-6618
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | GA1740 | Georgia |
| Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | GA1740 | Georgia |
Profile Details
| NPI number | 1386636256 |
|---|---|
| LBN Legal business name | Forche, Jon L |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 17th, 2005 |
| Last updated | Jun 29th, 2016 - about 8 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 | 1386636256 | NPPES |
| Georgia | MEDICAID | 000831377B | |
| Georgia | Other | 582102247 | |
| Georgia | MEDICAID | 000831377A | |
| Georgia | Other | 667222 |
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