Healthcare Provider Details

I. General information

NPI: 1639325780
Provider Name (Legal Business Name): JENNIFER G. SLOTWINSKI O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER G. KOLODZIEJCZYK O.D.

II. Dates (important events)

Enumeration Date: 08/08/2008
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3640 MUNDY MILL RD STE 146
GAINESVILLE GA
30504-8201
US

IV. Provider business mailing address

5524 BRENDLYNN DR
SUWANEE GA
30024-7553
US

V. Phone/Fax

Practice location:
  • Phone: 470-290-8182
  • Fax: 470-481-0250
Mailing address:
  • Phone: 630-269-0760
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT003224
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: