Painter, Jon E

Painter, Jon E is an sole proprietor health care provider with primary practice located at 619 N Broadway St , Moore OK 73160-4813. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Painter, Jon E can be contacted via phone (405) 799-7706.

Contact Information

Primary practice address
619 N Broadway St Moore OK 73160-4813
Fax: (405) 799-7715
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 2048 Oklahoma

Profile Details

NPI number 1679585566
LBN Legal business name Painter, Jon E
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 12th, 2006
Last updated Sep 1st, 2010 - about 14 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 1679585566 NPPES
Oklahoma MEDICAID 100762190A
Oklahoma Other 441729242001

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