MEDICARE: KERRY K JARVIS OD PLLC

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

General Provider Information

NPI Number	:	1134778566
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KERRY K JARVIS OD PLLC

Provider Business Mailing Address
First Line	:	1575 S JACKSON ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80210-3026
Country	:	US
Telephone Number	:	970-590-7951
Fax Number	:

Provider Business Practice Location Address
First Line	:	333 S ALLISON PKWY STE 120
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80226-3115
Country	:	US
Telephone Number	:	303-989-2020
Fax Number	:	844-875-0149

Authorized Official
Title or Position	:	OWNER
Name	:	DR. KERRY K JARVIS
Credential	:	OD
Telephone Number	:	303-989-2020

Provider Enumeration Date	:	09/09/2019
Last Update Date	:	09/09/2019

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