Jicha, John Joseph

Jicha, John Joseph is an individual health care provider with primary practice located at 3911 Fountain Grove Dr Suite 101, High Point NC 27265-8032. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Jicha, John Joseph can be contacted via phone (336) 889-2225.

Contact Information

Primary practice address
3911 Fountain Grove Dr Suite 101 High Point NC 27265-8032
Fax: (336) 889-2252
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 1391 North Carolina

Profile Details

NPI number 1376527705
LBN Legal business name Jicha, John Joseph
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 30th, 2005
Last updated Nov 14th, 2017 - about 7 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 1376527705 NPPES
North Carolina MEDICAID 89015MC
North Carolina Other 09458
North Carolina MEDICAID 8909438
North Carolina Other 015MC
North Carolina Other 1391

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