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NPI Code Detail

MEDICARE: JADE MCLACHLIN OD

MEDICARE:   JADE  MCLACHLIN  OD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometristOPT.0003504CO

General Provider Information

NPI Number : 1063073245
Entity Type Code : Individual
Provider Name (Legal Business Name) : JADE MCLACHLIN OD
Provider Business Mailing Address
First Line : 6160 TUTT BLVD STE 201
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80923-3500
Country : US
Telephone Number : 719-598-5068
Fax Number : 719-632-6088
Provider Business Practice Location Address
First Line : 6160 TUTT BLVD STE 220
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80923-3502
Country : US
Telephone Number : 719-598-5068
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2019
Last Update Date : 10/05/2021

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Directions to “ JADE MCLACHLIN OD” Practice Location

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