Gutfleisch, James Robert
Gutfleisch, James Robert is an sole proprietor health care provider with primary practice located at 710 Division St-South Suite A, Northfield MN 55057-2468. 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. Gutfleisch, James Robert can be contacted via phone (507) 645-2261.Contact Information
Primary practice address
710 Division St-South Suite A
Northfield MN 55057-2468
Phone: (507) 645-2261
Fax: (507) 786-9703
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | LD1848000 | Minnesota |
| Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | LD1848000 | Minnesota |
Profile Details
| NPI number | 1982600524 |
|---|---|
| LBN Legal business name | Gutfleisch, James Robert |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 27th, 2005 |
| Last updated | Jul 26th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1982600524 | NPPES |
| Minnesota | Other | 177K2GU | BLUE CROSS BLUE SHIELD MN |
| Minnesota | Other | 526004 | BLUE CROSS BLUE SHIELD MN |
| Minnesota | Other | 106257 | BLUE CROSS BLUE SHIELD MN |
| Minnesota | MEDICAID | 6463231-00 | BLUE CROSS BLUE SHIELD MN |
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