Kiracofe, Gregory
Kiracofe, Gregory is an individual health care provider with primary practice located at 1222 S Patterson Blvd , Dayton OH 45402-2684. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Kiracofe, Gregory can be contacted via phone (937) 224-0024.Contact Information
Primary practice address
1222 S Patterson Blvd
Dayton OH 45402-2684
Phone: (937) 224-0024
Fax: (937) 224-4298
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 3543 T313 | Ohio |
Profile Details
| NPI number | 1184688384 |
|---|---|
| LBN Legal business name | Kiracofe, Gregory |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 14th, 2006 |
| Last updated | Jul 8th, 2007 - 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 | 1184688384 | NPPES |
| Ohio | MEDICAID | 0979213 |
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