Greene, Raymond Karl

Greene, Raymond Karl is an sole proprietor health care provider with primary practice located at 850 W Ironwood Dr Suite 104, Coeur D Alene ID 83814-4903. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Greene, Raymond Karl can be contacted via phone (208) 765-2020.

Contact Information

Primary practice address
850 W Ironwood Dr Suite 104 Coeur D Alene ID 83814-4903
Fax: (208) 765-1460
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 845 Idaho

Profile Details

NPI number 1689669798
LBN Legal business name Greene, Raymond Karl
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 14th, 2005
Last updated Mar 12th, 2008 - about 16 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 1689669798 NPPES
Idaho MEDICAID 002691400

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