Theobald, Martin J

Theobald, Martin J is an individual health care provider with primary practice located at 3308 W Arrowhead Rd , Duluth MN 55811-4000. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Theobald, Martin J can be contacted via phone (218) 727-6400.

Contact Information

Primary practice address
3308 W Arrowhead Rd Duluth MN 55811-4000
Phone: (218) 727-6400
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 2549 Minnesota

Profile Details

NPI number 1609842210
LBN Legal business name Theobald, Martin J
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 23rd, 2006
Last updated Jul 8th, 2007 - about 17 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 1609842210 NPPES
Minnesota Other A62871023475 PREFERRED ONE
Minnesota Other 110960 PREFERRED ONE
Minnesota Other 2207594 PREFERRED ONE
Minnesota Other 6C248TH PREFERRED ONE
Minnesota Other 897821023475 PREFERRED ONE
Minnesota Other 6C248TH PREFERRED ONE
Minnesota Other 2203074 PREFERRED ONE

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