Gustafson, Paul L.
Gustafson, Paul L. is an sole proprietor health care provider with primary practice located at 543 S David St , Casper WY 82601-3196. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Gustafson, Paul L. can be contacted via phone (307) 237-9494.Contact Information
Primary practice address
543 S David St
Casper WY 82601-3196
Phone: (307) 237-9494
Fax: (307) 237-1370
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 267T | Wyoming |
Profile Details
| NPI number | 1184666422 |
|---|---|
| LBN Legal business name | Gustafson, Paul L. |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 12th, 2006 |
| Last updated | Oct 20th, 2015 - about 9 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 | 1184666422 | NPPES |
| Wyoming | MEDICAID | 115863500 |
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