Wine, Douglas J
Wine, Douglas J is an sole proprietor health care provider with primary practice located at 140 W Spring St , Saint Marys OH 45885-2312. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Wine, Douglas J can be contacted via phone (419) 394-2397.Contact Information
Primary practice address
140 W Spring St
Saint Marys OH 45885-2312
Phone: (419) 394-2397
Fax: (419) 394-2398
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 3979 | Ohio |
| Eye and Vision Services Providers / Optometrist | 152W00000X | T1670 | Ohio |
Profile Details
| NPI number | 1376643445 |
|---|---|
| LBN Legal business name | Wine, Douglas J |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 25th, 2006 |
| Last updated | Sep 29th, 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 | 1376643445 | NPPES |
| Ohio | MEDICAID | 0916941 |
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