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:
Health care specialties
| Specialty | Code | License # | 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 15 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 | 1326148933 | NPPES |
| Iowa | Other | 18665 | MIDLANDS CHOICE |
| Iowa | Other | 26387 | MIDLANDS CHOICE |
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