MEDICARE: JAN JAY RIGNEY O.D. INC.

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	:	1295982635
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAN JAY RIGNEY O.D. INC.

Provider Business Mailing Address
First Line	:	11880 E 86TH ST N
Second Line	:
City	:	OWASSO
State	:	OK
Zip	:	74055-2535
Country	:	US
Telephone Number	:	918-272-3937
Fax Number	:	918-272-4251

Provider Business Practice Location Address
First Line	:	11880 E 86TH ST N
Second Line	:
City	:	OWASSO
State	:	OK
Zip	:	74055-2535
Country	:	US
Telephone Number	:	918-272-3937
Fax Number	:	918-272-4251

Authorized Official
Title or Position	:	OWNER/DOCTOR
Name	:	DR. JAN JAY RIGNEY
Credential	:	O.D.
Telephone Number	:	918-272-3937

Provider Enumeration Date	:	08/27/2008
Last Update Date	:	10/26/2011

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