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General NPI Number Information
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NPI Number | 1528037439
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Entity Type | Organization
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Legal Business Name | SCHLETZBAUM OPTOMETRY, INC.
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Dates
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Enumeration Date | 03/14/2006
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Last Update Date | 01/06/2011
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Provider Practice Location Address
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Address Line | 2311 N WALDRON ST
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City | HUTCHINSON
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State | KS
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Zip | 67502-1133
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Country | US
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Telephone | 620-663-4467
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Fax | 620-663-5007
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Provider Business Mailing Address
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Address Line | 2311 N WALDRON ST
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City | HUTCHINSON
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State | KS
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Zip | 67502-1133
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Country | US
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Telephone | 620-663-4467
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Fax | 620-663-5007
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Authorized Official
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Title or Position | OWNER
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Name | JEFFERY JOHN SCHLETZBAUM
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Credential | O.D.
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Telephone | 620-663-4467
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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 | 1663
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | 950-3
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License Number State | KS
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Taxonomy #3
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | 1663
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License Number State | KS
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Taxonomy #4
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Taxonomy Code | 152WP0200X
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Taxonomy Name | Pediatric Optometrist
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License Number | 1663
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License Number State | KS
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Taxonomy #5
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Taxonomy Code | 152WV0400X
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Taxonomy Name | Vision Therapy Optometrist
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License Number | 1663
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License Number State | KS
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Taxonomy #6
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 950-3
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License Number State | KS
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