Mendenhall, Jess Eric
Mendenhall, Jess Eric is an sole proprietor health care provider with primary practice located at 482 S Main St , Spanish Fork UT 84660-2410. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Mendenhall, Jess Eric can be contacted via phone (801) 504-6448.Contact Information
Primary practice address
482 S Main St
Spanish Fork UT 84660-2410
Phone: (801) 504-6448
Fax: (801) 504-6239
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 7070612-9934 | Utah |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 7070612-8908 | Utah |
Profile Details
| NPI number | 1225280423 |
|---|---|
| LBN Legal business name | Mendenhall, Jess Eric |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 21st, 2008 |
| Last updated | Dec 8th, 2014 - about 10 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 | 1225280423 | NPPES |
| Other | 12457053 | CAQH | |
| MEDICAID | 1225280423 | CAQH |
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