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General NPI Number Information
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NPI Number | 1609975085
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Entity Type | Individual
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Provider Name | JEFFREY C. NATCHEZ O.D.
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Gender | Male
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4152 E COURT ST
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City | BURTON
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State | MI
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Zip | 48509-1718
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Country | US
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Telephone | 810-743-4400
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Fax |
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Provider Business Mailing Address
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Address Line | 13154 MERGANZER CT
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City | LINDEN
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State | MI
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Zip | 48451-8413
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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 |
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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 | 4901002920
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License Number State | MI
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