Mahoney, John Todd
Mahoney, John Todd is an individual health care provider with primary practice located at 3726 Avenue D , Scottsbluff NE 69361-4665. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Mahoney, John Todd can be contacted via phone (308) 635-1234.Contact Information
Primary practice address
3726 Avenue D
Scottsbluff NE 69361-4665
Phone: (308) 635-1234
Fax: (308) 635-7505
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 174T | Wyoming |
Profile Details
| NPI number | 1467514646 |
|---|---|
| LBN Legal business name | Mahoney, John Todd |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 14th, 2006 |
| Last updated | Jul 20th, 2022 - about 2 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 | 1467514646 | NPPES |
| Wyoming | MEDICAID | 103472300 | |
| Wyoming | Other | 410017084 | |
| Wyoming | Other | 310524 |
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