Moon, Stephen L

Moon, Stephen L is an individual health care provider with primary practice located at 1322 Locust Ave , Fairmont WV 26554-1436. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Moon, Stephen L can be contacted via phone (304) 366-0700.

Contact Information

Primary practice address
1322 Locust Ave Fairmont WV 26554-1436
Phone: (304) 366-0700
Fax: (304) 367-8766
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 783D West Virginia

Profile Details

NPI number 1558393975
LBN Legal business name Moon, Stephen L
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2006
Last updated Apr 10th, 2018 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558393975 NPPES
West Virginia Other 227498 OPTIMUM CHOICE
West Virginia Other V27522 OPTIMUM CHOICE
West Virginia Other 505817 OPTIMUM CHOICE
West Virginia Other 001718661 OPTIMUM CHOICE
West Virginia Other 0004613017 OPTIMUM CHOICE
West Virginia MEDICAID 0150898000 OPTIMUM CHOICE
West Virginia Other 410025059 OPTIMUM CHOICE
West Virginia Other FQ783 OPTIMUM CHOICE

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