Porisch, Eric D
Porisch, Eric D is an individual health care provider with primary practice located at 605 Saint Joseph St , Rapid City SD 57701-2718. He recently has 5 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 / Pediatrics, Eye and Vision Services Providers / Sports Vision, Eye and Vision Services Providers / Occupational Vision. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Porisch, Eric D can be contacted via phone (605) 341-5644.Contact Information
Primary practice address
605 Saint Joseph St
Rapid City SD 57701-2718
Phone: (605) 341-5644
Fax: (605) 341-5450
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 604 | South Dakota |
| Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | 604 | South Dakota |
| Eye and Vision Services Providers / Pediatrics | 152WP0200X | 604 | South Dakota |
| Eye and Vision Services Providers / Sports Vision | 152WS0006X | 604 | South Dakota |
| Eye and Vision Services Providers / Occupational Vision | 152WX0102X | 604 | South Dakota |
Profile Details
| NPI number | 1174502330 |
|---|---|
| LBN Legal business name | Porisch, Eric D |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 15th, 2006 |
| Last updated | Jan 25th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1174502330 | NPPES |
| South Dakota | Other | 11336062 | CAQH |
| South Dakota | MEDICAID | 9203370 | CAQH |
| South Dakota | Other | S100185 | CAQH |
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