Ross, Jonathan Blake
Ross, Jonathan Blake is an individual health care provider with primary practice located at 1815 E Highland Dr , Jonesboro AR 72401-6118. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Ross, Jonathan Blake can be contacted via phone (870) 931-2020.Contact Information
Primary practice address
1815 E Highland Dr
Jonesboro AR 72401-6118
Phone: (870) 931-2020
Fax: (870) 932-8004
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2493 | Arkansas |
Profile Details
| NPI number | 1881638328 |
|---|---|
| LBN Legal business name | Ross, Jonathan Blake |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 15th, 2006 |
| Last updated | May 11th, 2009 - about 16 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 | 1881638328 | NPPES |
| Arkansas | MEDICAID | 141013722 | |
| Arkansas | Other | 49648 |
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