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General NPI Number Information
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NPI Number | 1194218313
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Entity Type | Individual
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Provider Name | COURTNEY L JAMESON O.D.
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Gender | Female
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Dates
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Enumeration Date | 06/12/2018
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Last Update Date | 10/11/2024
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Provider Practice Location Address
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Address Line | 50505 SCHOENHERR RD
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City | SHELBY TOWNSHIP
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State | MI
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Zip | 48315-3140
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Country | US
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Telephone | 586-803-3152
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Fax |
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Provider Business Mailing Address
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Address Line | 2535 JACLYN RD
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City | NORTH BRANCH
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State | MI
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Zip | 48461-8146
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Country | US
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Telephone | 810-305-2965
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 4901005120
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License Number State | MI
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