MEDICARE: DR. JEFFREY SCOTT LAUF O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	4028/T075	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043210883
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY SCOTT LAUF O.D.

Provider Business Mailing Address
First Line	:	606 N SCOTT ST
Second Line	:
City	:	NAPOLEON
State	:	OH
Zip	:	43545-1708
Country	:	US
Telephone Number	:	419-592-2021
Fax Number	:	419-592-4281

Provider Business Practice Location Address
First Line	:	606 N SCOTT ST
Second Line	:
City	:	NAPOLEON
State	:	OH
Zip	:	43545-1708
Country	:	US
Telephone Number	:	419-592-2021
Fax Number	:	419-592-4281

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/22/2005
Last Update Date	:	11/05/2008

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