Sorenson, Shawn C.

Sorenson, Shawn C. is an individual health care provider with primary practice located at 408 S Eagle Rd , Eagle ID 83616-6078. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Sorenson, Shawn C. can be contacted via phone (208) 939-2773.

Contact Information

Primary practice address
408 S Eagle Rd Eagle ID 83616-6078
Fax: (208) 938-5755
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X ODP-1058 Idaho

Profile Details

NPI number 1518922368
LBN Legal business name Sorenson, Shawn C.
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 17th, 2006
Last updated Feb 13th, 2017 - about 7 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 1518922368 NPPES
Idaho MEDICAID 806131200

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