Pruett, Stephen J
Pruett, Stephen J is an individual health care provider with primary practice located at 3805B Spring St Suite 140, Racine WI 53405-1641. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Pruett, Stephen J can be contacted via phone (262) 637-8835.Contact Information
Primary practice address
3805B Spring St Suite 140
Racine WI 53405-1641
Phone: (262) 637-8835
Fax: (262) 635-8027
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 1963-035 | Wisconsin |
Profile Details
| NPI number | 1427070259 |
|---|---|
| LBN Legal business name | Pruett, Stephen J |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 24th, 2006 |
| Last updated | Apr 18th, 2011 - about 13 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 | 1427070259 | NPPES |
| Wisconsin | MEDICAID | 38583200 |
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