Heiner, Dallin
Heiner, Dallin is an individual health care provider with primary practice located at 244 E Main St , Rexburg ID 83440-2022. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Heiner, Dallin can be contacted via phone (208) 359-1880.Contact Information
Primary practice address
244 E Main St
Rexburg ID 83440-2022
Phone: (208) 359-1880
Fax: (208) 359-2025
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | ODP 100060 | Idaho |
Profile Details
| NPI number | 1245346980 |
|---|---|
| LBN Legal business name | Heiner, Dallin |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 23rd, 2006 |
| Last updated | Sep 24th, 2008 - about 17 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 | 1245346980 | NPPES |
| Idaho | MEDICAID | 806951300 | |
| Idaho | Other | V6515 | |
| Idaho | Other | 000010147628 | |
| Idaho | Other | 857241 |
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