Lawrence Iden Hittle, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3089 Issued in MN

Practice address

205 12TH St S
Sauk Centre, MN 56378-1614

Phone

(320) 352-0146

Fax

(320) 352-0023

NPI assigned

Mar 14, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249344000000",
    "number": "1972636256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 ELM ST S",
            "city": "SAUK CENTRE",
            "state": "MN",
            "postal_code": "563781416",
            "telephone_number": "320-352-7876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 12TH ST S",
            "city": "SAUK CENTRE",
            "state": "MN",
            "postal_code": "563781614",
            "telephone_number": "320-352-0146",
            "fax_number": "320-352-0023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HITTLE",
        "first_name": "LAWRENCE",
        "middle_name": "IDEN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2009-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Sauk Centre, MN
• Providers in Sauk Centre, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.