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General NPI Number Information
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NPI Number | 1417103458
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Entity Type | Individual
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Provider Name | JESSICA N MAI OD
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Gender | Female
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Dates
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Enumeration Date | 08/11/2008
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Last Update Date | 01/11/2023
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Provider Practice Location Address
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Address Line | 1107 SW GAGE BLVD STE 200
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City | TOPEKA
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State | KS
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Zip | 66604-2098
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Country | US
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Telephone | 785-271-8989
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Fax | 785-228-0370
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Provider Business Mailing Address
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Address Line | 1107 SW GAGE BLVD STE 200
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City | TOPEKA
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State | KS
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Zip | 66604-2098
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Country | US
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Telephone | 785-271-8989
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Fax | 785-228-0370
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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 | 1813
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License Number State | KS
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