Pearson, Jack W.

Pearson, Jack W. is an individual health care provider with primary practice located at 615 S Mill St , Fergus Falls MN 56537-2756. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Pearson, Jack W. can be contacted via phone (218) 739-2221.

Contact Information

Primary practice address
615 S Mill St Fergus Falls MN 56537-2756
Phone: (218) 739-2221
Fax: (218) 739-5501
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 20760 Minnesota

Profile Details

NPI number 1619077674
LBN Legal business name Pearson, Jack W.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 22nd, 2006
Last updated Jul 9th, 2007 - about 18 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 1619077674 NPPES
Minnesota Other 61515PE BCBS
Minnesota Other 1008796 BCBS
Minnesota MEDICAID 13218 BCBS
Minnesota MEDICAID 41091744413 BCBS
Minnesota Other 08-01913 BCBS
Minnesota Other 109530 BCBS
Minnesota Other HP26722 BCBS

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