Jerge, Larry F
Jerge, Larry F is an sole proprietor health care provider with primary practice located at 1151 Stonecrest Blvd. , Fort Mill SC 29708. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Jerge, Larry F can be contacted via phone (803) 802-4733.Contact Information
Primary practice address
1151 Stonecrest Blvd.
Fort Mill SC 29708
Phone: (803) 802-4733
Fax: (803) 802-4735
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | UT-003877-1 | New York |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 1468 | South Carolina |
Profile Details
| NPI number | 1861492407 |
|---|---|
| LBN Legal business name | Jerge, Larry F |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 26th, 2005 |
| Last updated | Mar 4th, 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 | 1861492407 | NPPES |
| South Carolina | MEDICAID | D14688 |
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