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
Fax: (803) 802-4735
Website:

Health care specialties

SpecialtyCodeLicense #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 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861492407 NPPES
South Carolina MEDICAID D14688

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