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KENT M ARCHIBALD P.A. NPI 1447579123


NPI Information

NPI: 1447579123
Provider Name: KENT M ARCHIBALD P.A.
Classification: Optometrist - 152W00000X
Entity Type: Organization
Address:
76 PROFESSIONAL PLZ
REXBURG, ID
ZIP 83440
Phone: (208) 356-4585
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KENT M ARCHIBALD P.A. is an optometrist in Rexburg, ID. The provider is doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. KENT M ARCHIBALD P.A. NPI is 1447579123. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

76 PROFESSIONAL PLZ
REXBURG, ID
ZIP 83440-047
Phone: (208) 356-4585
Fax: (208) 356-4587

The provider's authorized official is Kent M Archibald .
The authorized official title is President and has the following contact phone number (208) 356-4585.

The enumeration date for this NPI number is 5/20/2010 and was last updated on 6/20/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1152W00000XOptometristOPD-513IDAHOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1=========OTHERIDAHODMBA
2002457600MEDICAIDIDAHO
3410007525OTHERIDAHORAIL ROAD
4ODP-513OTHERIDAHOIDAHO OPTOMETRY LICENSE
5V109-4OTHERIDAHOBLUE CROSS
600010015323OTHERIDAHOBLUE SHIELD

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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