Petersma, Jay D

Petersma, Jay D is an sole proprietor health care provider with primary practice located at 5501 Nw 86Th St Suite 500, Johnston IA 50131-1816. He recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Petersma, Jay D can be contacted via phone (515) 270-0494.

Contact Information

Primary practice address
5501 Nw 86Th St Suite 500 Johnston IA 50131-1816
Phone: (515) 270-0494
Fax: (515) 270-6463
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 01861 Iowa
Eye and Vision Services Providers / Corneal and Contact Management 152WC0802X 01861 Iowa

Profile Details

NPI number 1326148933
LBN Legal business name Petersma, Jay D
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 24th, 2006
Last updated Jan 11th, 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 1326148933 NPPES
Iowa Other 18665 MIDLANDS CHOICE
Iowa Other 26387 MIDLANDS CHOICE

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