Goggin, Stephanie R
Goggin, Stephanie R is an individual health care provider with primary practice located at 6620 Center Grove Road , Edwardsville IL 62025-2802. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Goggin, Stephanie R can be contacted via phone (618) 659-1900.Contact Information
Primary practice address
6620 Center Grove Road
Edwardsville IL 62025-2802
Phone: (618) 659-1900
Fax: (618) 659-1901
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 046-009281 | Illinois |
Profile Details
| NPI number | 1013965367 |
|---|---|
| LBN Legal business name | Goggin, Stephanie R |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 5th, 2006 |
| Last updated | Dec 8th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1013965367 | NPPES |
| Illinois | Other | 410043847 | RAILROAD MEDICARE - SFLD |
| Illinois | Other | 410043848 | RAILROAD MEDICARE - SFLD |
| Illinois | MEDICAID | 046009281 | RAILROAD MEDICARE - SFLD |
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