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General NPI Number Information
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NPI Number | 1184570921
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Entity Type | Organization
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Legal Business Name | ELLINGTON EYECARE PLLC
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Dates
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Enumeration Date | 03/05/2026
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Last Update Date | 03/05/2026
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Provider Practice Location Address
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Address Line | 10100 CANAL CROSSING
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City | BRUNSWICK
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State | GA
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Zip | 31525
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Country | US
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Telephone | 912-602-6805
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Fax |
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Provider Business Mailing Address
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Address Line | 4875 S JASON ST
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City | ENGLEWOOD
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State | CO
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Zip | 80110-6414
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | JACQUELINE CARMEN ELIZABETH EVANS
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Credential |
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Telephone | 303-445-9446
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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