Nelson, Michael Hennen

Nelson, Michael Hennen is an sole proprietor health care provider with primary practice located at 105 N York St , Muskogee OK 74403-4657. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Nelson, Michael Hennen can be contacted via phone (918) 682-2181.

Contact Information

Primary practice address
105 N York St Muskogee OK 74403-4657
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 926 Oklahoma

Profile Details

NPI number 1720070394
LBN Legal business name Nelson, Michael Hennen
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 18th, 2005
Last updated Jun 9th, 2008 - about 17 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 1720070394 NPPES
Oklahoma MEDICAID 100764840A

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