Gross, Douglas

Gross, Douglas is an sole proprietor health care provider with primary practice located at 207 County Road 120 , Saint Cloud MN 56303-4872. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Gross, Douglas can be contacted via phone (320) 202-5985.

Contact Information

Primary practice address
207 County Road 120 Saint Cloud MN 56303-4872
Phone: (320) 202-5985
Fax: (320) 202-7890
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 2083 Minnesota

Profile Details

NPI number 1033193511
LBN Legal business name Gross, Douglas
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 30th, 2005
Last updated Aug 23rd, 2010 - about 14 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 1033193511 NPPES
Minnesota MEDICAID 078223800
Minnesota Other 410032600
Minnesota Other 82973GR
Minnesota Other 22-24009
Minnesota Other HP27094

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