Siegmund, Jason

Siegmund, Jason is an individual health care provider with primary practice located at 540 Seaboard St , Myrtle Beach SC 29577. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Siegmund, Jason can be contacted via phone (843) 626-6210.

Contact Information

Primary practice address
540 Seaboard St Myrtle Beach SC 29577
Phone: (843) 626-6210
Fax: (843) 692-3094
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X SC1389 South Carolina

Profile Details

NPI number 1073675690
LBN Legal business name Siegmund, Jason
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 14th, 2006
Last updated Jan 9th, 2015 - about 9 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 1073675690 NPPES
South Carolina Other 41155 SPECTERA
South Carolina MEDICAID D13894 SPECTERA

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