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NPI Code Detail

MEDICARE: JENNIFER ENG OD

MEDICARE: JENNIFER ENG OD
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
1152W00000XOptometrist10178TGTX
2152W00000XOptometrist0003633CO
3152W00000XOptometrist3122OK

General Provider Information

NPI Number : 1578155982
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER ENG OD
Provider Business Mailing Address
First Line : 2640 MINER RD
Second Line :
City : FORT SILL
State : OK
Zip : 73503-4437
Country : US
Telephone Number : 580-585-5600
Fax Number :
Provider Business Practice Location Address
First Line : 2640 MINER RD
Second Line :
City : FORT SILL
State : OK
Zip : 73503-4437
Country : US
Telephone Number : 580-585-5600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2021
Last Update Date : 11/21/2022

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