Mckenna, John David
Mckenna, John David is an sole proprietor health care provider with primary practice located at 1511 N Post Rd , Indianapolis IN 46219-4247. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Mckenna, John David can be contacted via phone (317) 899-1017.Contact Information
Primary practice address
1511 N Post Rd
Indianapolis IN 46219-4247
Phone: (317) 899-1017
Fax: (317) 899-1660
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 18003120B | Indiana |
Profile Details
| NPI number | 1104825900 |
|---|---|
| LBN Legal business name | Mckenna, John David |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 14th, 2005 |
| Last updated | Aug 3rd, 2012 - about 12 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 | 1104825900 | NPPES |
| Indiana | Other | P00701435 | MEDICARE RAILROAD |
| Indiana | MEDICAID | 1104825900 | MEDICARE RAILROAD |
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