Individual
JACK B VONTILLIUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD0000002781
TN
152W00000X
Optometrist
OP002631
GA
152W00000X
Optometrist
TUV007223
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1515043
—
TN
01
—
4230667
BCBS OF TN
TN
Enumeration date
11/21/2007
Last updated
06/27/2013
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up