Jake P Bostrom in Spartanburg - Ophthalmology
Jake P Bostrom - NPI 1295886125
Jake P Bostrom is a Ophthalmology in Spartanburg, South Carolina. Jake P Bostrom practices all healthcare services and medical treatments related to Ophthalmology. The NPI Number for Jake P Bostrom is 1295886125. The last update date is 2019-07-09.
Jake P Bostrom's current location address is 479 Heywood Ave, Spartanburg, South Carolina. You can contact this provider via phone number 8645836381 and fax number 8645836390. The mailing address for Jake P Bostrom is 479 Heywood Ave, Spartanburg, South Carolina. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jake P Bostrom |
|---|---|
| Address | 479 Heywood Ave, Spartanburg, South Carolina |
| Phone Number | 8645836381 |
| Fax Number | 8645836390 |
| Sole Proprietor | N |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1295886125 |
|---|---|
| Provider Enumeration Date | 2007-01-16 |
| Last Updated Date | 2019-07-09 |
Provider Mailing Address Detail
| Address | 479 Heywood Ave |
|---|---|
| City | Spartanburg |
| State | South Carolina (SC) |
| Post Code | 293071726 |
| Phone Number | 8645836381 |
| Fax Number | 8645836390 |
Provider's Primary Taxonomy Detail
| Speciality | Ophthalmology |
|---|---|
| Taxonomy | 207W00000X |
| Licence No | 31615 |
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Definition: An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This incl |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| AA3955-7292 | SC | MEDICARE PTAN | |
| 31615 | SC | SC LICENSE | |
| 1457384729 | SC | GROUP NPI | |
| 316152 | SC | -- | |
| P01501403 | SC | RR MEDICARE |
Post Comment/ Review Below
What is the unique provider identifier assigned to Jake P Bostrom?
The Jake P Bostrom has been issued the NPI (National Provider Identifier) 1295886125 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you please share the complete physical address where Jake P Bostrom is geographically located?
The Jake P Bostrom is physically situated at the following location: 479 Heywood Ave, Spartanburg, SC, 293071726.
What is the Jake P Bostrom's specialty and taxonomy code?
The Jake P Bostrom's specialty is Ophthalmology, and the corresponding taxonomy code is 207W00000X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1295886125 to Jake P Bostrom?
The Centers for Medicare & Medicaid Services originally issued the 1295886125 to Jake P Bostrom on 2007-01-16.
As of what date was the information pertaining to Jake P Bostrom, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Jake P Bostrom, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2019-07-09.
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