Stults, Kenneth D

Stults, Kenneth D is an individual health care provider with primary practice located at 1610 W Townline St Ste 115, Creston IA 50801-1064. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Stults, Kenneth D can be contacted via phone (641) 782-7619.

Contact Information

Primary practice address
1610 W Townline St Ste 115 Creston IA 50801-1064
Phone: (641) 782-7619
Fax: (641) 782-6549
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 02061 Iowa

Profile Details

NPI number 1982608865
LBN Legal business name Stults, Kenneth D
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2005
Last updated Nov 27th, 2007 - about 18 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 1982608865 NPPES
Iowa Other 51981 BLUE CROSS BLUE SHIELD
Iowa Other 1520261 BLUE CROSS BLUE SHIELD
Iowa MEDICAID 0128975 BLUE CROSS BLUE SHIELD
Iowa Other 02061 BLUE CROSS BLUE SHIELD

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