West, Jerry Dean
West, Jerry Dean is an sole proprietor health care provider with primary practice located at 7171 S Yale Ave Ste 104, Tulsa OK 74136-6367. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. West, Jerry Dean can be contacted via phone (918) 492-1722.Contact Information
Primary practice address
7171 S Yale Ave Ste 104
Tulsa OK 74136-6367
Phone: (918) 492-1722
Fax: (918) 492-3578
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 0853 | Oklahoma |
Profile Details
| NPI number | 1669478962 |
|---|---|
| LBN Legal business name | West, Jerry Dean |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 22nd, 2005 |
| Last updated | Jun 16th, 2010 - about 15 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 | 1669478962 | NPPES |
| Other | 4486602 | AETNA | |
| MEDICAID | 100764250A | AETNA |
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