Horak, Ivo
Horak, Ivo is an sole proprietor health care provider with primary practice located at 47 Gramling St Se , Marietta GA 30008-2517. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Horak, Ivo can be contacted via phone (770) 436-9123.Contact Information
Primary practice address
47 Gramling St Se
Marietta GA 30008-2517
Phone: (770) 436-9123
Fax: (770) 436-9193
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 1556 | Georgia |
Profile Details
| NPI number | 1396791935 |
|---|---|
| LBN Legal business name | Horak, Ivo |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 25th, 2006 |
| Last updated | Aug 15th, 2023 - about last year |
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 | 1396791935 | NPPES |
| Georgia | MEDICAID | 267216858A | |
| Georgia | MEDICAID | 267216858B |
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