Nave, Jerry Blair
Nave, Jerry Blair is an individual health care provider with primary practice located at 2550 S 25Th E , Idaho Falls ID 83404. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Nave, Jerry Blair can be contacted via phone (208) 552-7323.Contact Information
Primary practice address
2550 S 25Th E
Idaho Falls ID 83404
Phone: (208) 552-7323
Fax: (208) 552-7325
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 0818 | Idaho |
Profile Details
| NPI number | 1245340314 |
|---|---|
| LBN Legal business name | Nave, Jerry Blair |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 30th, 2006 |
| Last updated | Nov 10th, 2008 - about 16 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 | 1245340314 | NPPES |
| Idaho | Other | 1307550001 | NORIDIAN |
| Idaho | MEDICAID | 004321400 | NORIDIAN |
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