Van Loon, Derin John
Van Loon, Derin John is an sole proprietor health care provider with primary practice located at 213 W 1St St , Duluth MN 55802-1909. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Van Loon, Derin John can be contacted via phone (218) 727-1004.Contact Information
Primary practice address
213 W 1St St
Duluth MN 55802-1909
Phone: (218) 727-1004
Fax: (218) 727-1525
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2650 | Minnesota |
Profile Details
| NPI number | 1568440675 |
|---|---|
| LBN Legal business name | Van Loon, Derin John |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 9th, 2006 |
| Last updated | Jun 19th, 2018 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1568440675 | NPPES |
| Minnesota | MEDICAID | 637896000 |
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