Whiteleather, Kevin A.
Whiteleather, Kevin A. is an sole proprietor health care provider with primary practice located at 4201 Lahmeyer Rd , Fort Wayne IN 46815-5676. He recently has 3 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Low Vision Rehabilitation, Eye and Vision Services Providers / Corneal and Contact Management. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Whiteleather, Kevin A. can be contacted via phone (260) 486-6106.Contact Information
Primary practice address
4201 Lahmeyer Rd
Fort Wayne IN 46815-5676
Phone: (260) 486-6106
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 18003140A | Indiana |
| Eye and Vision Services Providers / Low Vision Rehabilitation | 152WL0500X | 18003140A | Indiana |
| Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | 18003140A | Indiana |
Profile Details
| NPI number | 1497758395 |
|---|---|
| LBN Legal business name | Whiteleather, Kevin A. |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 24th, 2005 |
| Last updated | Oct 26th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1497758395 | NPPES |
| Indiana | Other | 7470288 | AETNA PROVIDER NUMBER |
| Indiana | Other | 000000225758 | AETNA PROVIDER NUMBER |
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