Sparks, Jennifer Dawn

Sparks, Jennifer Dawn is an individual health care provider with primary practice located at 629 Main St , Klamath Falls OR 97601-6007. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Sparks, Jennifer Dawn can be contacted via phone (541) 884-8322.

Contact Information

Primary practice address
629 Main St Klamath Falls OR 97601-6007
Phone: (541) 884-8322
Fax: (541) 884-7121
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 2975T Oregon

Profile Details

NPI number 1285694000
LBN Legal business name Sparks, Jennifer Dawn
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 24th, 2006
Last updated Jul 17th, 2012 - about 12 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285694000 NPPES
Oregon Other P00208178 RAILROAD MEDICARE
Oregon MEDICAID 022812 RAILROAD MEDICARE
Oregon Other XSD000850 RAILROAD MEDICARE
Oregon Other 004571011 RAILROAD MEDICARE
Oregon Other XSD000860 RAILROAD MEDICARE

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