Idocs Of Dodge City, Pa

LBN: Idocs Of Dodge City, Pa
Idocs Of Dodge City, Pa is an health care organization with primary practice located at 2520 N 14Th Ave , Dodge City KS 67801-2315. The organization recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as the primary health care specialty. Idocs Of Dodge City, Pa can be contacted via phone (620) 227-3071, or through Gwaltney, Jordan E via phone (620) 227-3071.

Contact Information

Primary practice address
2520 N 14Th Ave Dodge City KS 67801-2315
Phone: (620) 227-3071
Fax: (620) 227-6911
Website:
Map and Directions
Authorized official contact:
Name: Gwaltney, Jordan E Doctor of Optometry (OD)
Phone: (620) 227-3071

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 1744 Kansas

Profile Details

NPI number 1588785786
LBN Legal business name Idocs Of Dodge City, Pa
DBA Doing business as
Authorized official Gwaltney, Jordan E Doctor of Optometry (OD)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 3rd, 2007
Last updated Jun 5th, 2009 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588785786 NPPES
Kansas MEDICAID 100090850A
Kansas Other 043311
Kansas MEDICAID 200399790A
Kansas MEDICAID 100219900A
Kansas Other C57955

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