Jackson Condon, Kelley R
Jackson Condon, Kelley R is an sole proprietor health care provider with primary practice located at 1409 Washington Ave , Golden CO 80401. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Jackson Condon, Kelley R can be contacted via phone (303) 271-1400.Contact Information
Primary practice address
1409 Washington Ave
Golden CO 80401
Phone: (303) 271-1400
Fax: (303) 271-9314
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | CO1678 | Colorado |
Profile Details
| NPI number | 1275649444 |
|---|---|
| LBN Legal business name | Jackson Condon, Kelley R |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 21st, 2006 |
| Last updated | Mar 4th, 2009 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1275649444 | NPPES |
| Colorado | MEDICAID | 08016784 |
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