Hatch, Rustin M

Hatch, Rustin M is an individual health care provider with primary practice located at 526 Shoup Ave W Ste H, Twin Falls ID 83301. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Hatch, Rustin M can be contacted via phone (208) 733-2400.

Contact Information

Primary practice address
526 Shoup Ave W Ste H Twin Falls ID 83301
Fax: (208) 734-0343
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X ODP-100048 Idaho

Profile Details

NPI number 1265402911
LBN Legal business name Hatch, Rustin M
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 25th, 2006
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 1265402911 NPPES
Idaho MEDICAID 806835700

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