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PAUL C JACOBS TREVOR CRABTREE PTR NPI 1649475328


NPI Information

NPI: 1649475328
Provider Name: PAUL C JACOBS TREVOR CRABTREE PTR

Doing Business As: JACOBS & CRABTREE DCTRS OF OPTOMETRY

Classification: Optometrist - 152WC0802X
Entity Type: Organization

Specialization: Corneal and Contact Management

Address:
223 N PARK AVE
HERRIN, IL
ZIP 62948
Phone: (618) 942-6887
Get Directions

PAUL C JACOBS TREVOR CRABTREE PTR is a corneal and contact management optometrist in Herrin, IL. The provider is the professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea's ability to sustain successful contact lens wear, and treatment of any external eye or corneal condition which can affect contact lens wear. PAUL C JACOBS TREVOR CRABTREE PTR NPI is 1649475328. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Jacobs & Crabtree Dctrs Of Optometry.

The provider's business location address is:

223 N PARK AVE
HERRIN, IL
ZIP 62948-149
Phone: (618) 942-6887
Fax: (618) 988-1209

The provider's authorized official is Carolyn Sue Keller .
The authorized official title is Office Manager and has the following contact phone number (618) 993-8787.

The enumeration date for this NPI number is 6/20/2007 and was last updated on 12/17/2014.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1152WC0802XOptometristCorneal and Contact Management046-008310ILLINOISYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10709640001MEDICARE NSC
2931260MEDICARE PIN

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: 5/5/2024

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