Lister, Jedediah Beal
Lister, Jedediah Beal is an individual health care provider with primary practice located at 15 S River Rd Ste 150 , St George UT 84790-2106. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Eye and Vision Services Providers / Optometrist. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Lister, Jedediah Beal can be contacted via phone (435) 465-2230.Contact Information
Primary practice address
15 S River Rd Ste 150
St George UT 84790-2106
Phone: (435) 465-2230
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Eye and Vision Services Providers / Optometrist | 152W00000X | 678 | New Mexico |
Profile Details
| NPI number | 1831442656 |
|---|---|
| LBN Legal business name | Lister, Jedediah Beal |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 17th, 2012 |
| Last updated | Aug 26th, 2020 - about 4 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 | 1831442656 | NPPES |
| New Mexico | Other | 678 | NM STATE LICENSE |
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