Sally Beth Jackula in Saint Cloud - Optometrist
Sally Beth Jackula - NPI 1902804149
Sally Beth Jackula is a Optometrist in Saint Cloud, Minnesota. Sally Beth Jackula practices all healthcare services and medical treatments related to Optometrist. The NPI Number for Sally Beth Jackula is 1902804149. The last update date is 2021-03-16.
Sally Beth Jackula's current location address is 3112 Southway Dr, Saint Cloud, Minnesota. You can contact this provider via phone number 3202574747 and fax number 3202627118. The mailing address for Sally Beth Jackula is 3112 Southway Dr, Saint Cloud, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Sally Beth Jackula |
|---|---|
| Address | 3112 Southway Dr, Saint Cloud, Minnesota |
| Phone Number | 3202574747 |
| Fax Number | 3202627118 |
| Sole Proprietor | Y |
| Credentials | OD |
NPI Number Detail
| NPI Number | 1902804149 |
|---|---|
| Provider Enumeration Date | 2005-07-12 |
| Last Updated Date | 2021-03-16 |
Provider Mailing Address Detail
| Address | 3112 Southway Dr |
|---|---|
| City | Saint Cloud |
| State | Minnesota (MN) |
| Post Code | 563019589 |
| Phone Number | 3202574747 |
| Fax Number | 3202627118 |
Provider's Primary Taxonomy Detail
| Speciality | Optometrist |
|---|---|
| Taxonomy | 152W00000X |
| Licence No | 2895 |
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Definition: 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 |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 207837 | MN | 207837 | |
| 22-01872 | MN | MEDICA | |
| 125T6JA | MN | BCBS | |
| 126382000 | MN | -- | |
| 141351 | MN | UCARE | |
| 964141032721 | MN | P-1 | |
| HP37041 | MN | HP |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Sally Beth Jackula by the Centers for Medicare & Medicaid Services?
The Sally Beth Jackula has been assigned the NPI (National Provider Identifier) 1902804149 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you share the physical location details of Sally Beth Jackula?
The Sally Beth Jackula is situated at 3112 Southway Dr, in the city of Saint Cloud, state of MN, with the zip code 563019589.
What is Sally Beth Jackula's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Sally Beth Jackula is Optometrist, and the taxonomy classification code that categorizes this area of expertise is 152W00000X.
When did Sally Beth Jackula receive its 1902804149 assignment?
The Sally Beth Jackula was assigned its 1902804149 on 2005-07-12, which is the date when this unique identifier was issued to the organization.
As of what date were the details pertaining to Sally Beth Jackula last refreshed?
The information related to the Sally Beth Jackula, including its address, specialty, and other relevant details, was last updated on 2021-03-16.
NPI Number: 1528061710
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