Knezich, Andrew Glen
Knezich, Andrew Glen is an individual health care provider with primary practice located at 1501 Newcastle St , Brunswick GA 31520-6806. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Knezich, Andrew Glen can be contacted via phone (912) 280-0012.Contact Information
Primary practice address
1501 Newcastle St
Brunswick GA 31520-6806
Phone: (912) 280-0012
Fax: (912) 280-0991
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | OPT001803 | Georgia |
Profile Details
| NPI number | 1578546214 |
|---|---|
| LBN Legal business name | Knezich, Andrew Glen |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 28th, 2005 |
| Last updated | Oct 12th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1578546214 | NPPES |
| Georgia | Other | 582646940 | NVA |
| Georgia | MEDICAID | 209089721A | NVA |
| Georgia | Other | POO149589 | NVA |
| Georgia | Other | GK22894 | NVA |
| Georgia | Other | GA1803 | NVA |
| Georgia | Other | 32774 | NVA |
| Georgia | Other | 6599375 | NVA |
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