Hostetler, Jack L
Hostetler, Jack L is an individual health care provider with primary practice located at 2680 S Val Vista Dr #111, Gilbert AZ 85295-2152. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Hostetler, Jack L can be contacted via phone (480) 807-0288.Contact Information
Primary practice address
2680 S Val Vista Dr #111
Gilbert AZ 85295-2152
Phone: (480) 807-0288
Fax: (480) 299-7199
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 349 | Arizona |
Profile Details
| NPI number | 1760486500 |
|---|---|
| LBN Legal business name | Hostetler, Jack L |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 9th, 2005 |
| Last updated | Jun 25th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1760486500 | NPPES |
| Arizona | MEDICAID | 860439395 |
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