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General NPI Number Information
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NPI Number | 1720311566
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Entity Type | Organization
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Legal Business Name | JING YE, OD., LLC
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Dates
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Enumeration Date | 09/11/2009
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Last Update Date | 07/17/2015
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Provider Practice Location Address
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Address Line | 241 E LINWOOD BLVD
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City | KANSAS CITY
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State | MO
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Zip | 64111-1119
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Country | US
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Telephone | 816-931-4515
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Fax | 816-931-4515
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Provider Business Mailing Address
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Address Line | 4121 BLACKJACK OAK DR
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City | LAWRENCE
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State | KS
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Zip | 66047-1946
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Country | US
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Telephone | 785-393-3622
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Fax | 785-856-2036
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JING YE
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Credential | O.D.
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Telephone | 816-931-4515
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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 | 2006022865
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License Number State | MO
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