Healthcare Provider Details

I. General information

NPI: 1437488145
Provider Name (Legal Business Name): JURY EYE CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2009
Last Update Date: 08/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1918 N ROCK RD SUITE 800
DERBY KS
67037-3778
US

IV. Provider business mailing address

1918 N ROCK RD SUITE 800
DERBY KS
67037-3778
US

V. Phone/Fax

Practice location:
  • Phone: 316-558-5400
  • Fax: 678-928-0651
Mailing address:
  • Phone: 316-558-5400
  • Fax: 678-928-0651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1282-3
License Number StateKS

VIII. Authorized Official

Name: DR. JAMES S JURY
Title or Position: MEMBER
Credential: O. D.
Phone: 316-558-5400