Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 5627 | OH |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 5627 | OH |
N | 152WP0200X | Pediatric Optomitrist | 5627 | OH |
NPI | 1013017656 |
---|---|
Provider Name | Dr. James J Jankowski |
First Address | Ironton, OH 45638-1638 |
Second Address | Ironton, OH 45638-1638 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/09/2006 |
Last Update Date | 22/09/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
V11331 | (02) | OH |