MEDICARE: DR. JEFFREY SCOTT FOREMAN O.D.

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
1	152W00000X	Optometrist	01739	IA

General Provider Information

NPI Number	:	1205808359
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY SCOTT FOREMAN O.D.

Provider Business Mailing Address
First Line	:	1511 1ST AVE S
Second Line	:
City	:	FORT DODGE
State	:	IA
Zip	:	50501-5012
Country	:	US
Telephone Number	:	515-955-7777
Fax Number	:

Provider Business Practice Location Address
First Line	:	1511 1ST AVE S
Second Line	:
City	:	FORT DODGE
State	:	IA
Zip	:	50501-5012
Country	:	US
Telephone Number	:	515-955-7777
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/03/2006
Last Update Date	:	11/20/2024

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