Rothbloom, Stephen L

Rothbloom, Stephen L is an sole proprietor health care provider with primary practice located at 1655 Spring Road , Smyrna GA 30080. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Rothbloom, Stephen L can be contacted via phone (678) 842-9544.

Contact Information

Primary practice address
1655 Spring Road Smyrna GA 30080
Fax: (678) 842-9291
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 1090 Georgia

Profile Details

NPI number 1780686048
LBN Legal business name Rothbloom, Stephen L
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 1st, 2005
Last updated Apr 2nd, 2008 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780686048 NPPES
Georgia Other 205228732 CIGNA
Georgia Other 205228732 CIGNA
Georgia Other 205228732 CIGNA
Georgia MEDICAID 100781 CIGNA
Georgia Other 205228732 CIGNA
Georgia Other 205228732 CIGNA
Georgia Other 205228732 CIGNA

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