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NPI Code Detail

MEDICARE: DR. JENNIFER R THATCHER O.D.

MEDICARE: DR. JENNIFER R THATCHER 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
1152W00000XOptometrist13725CA
2152W00000XOptometrist6181OH

General Provider Information

NPI Number : 1851520043
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JENNIFER R THATCHER O.D.
Provider Business Mailing Address
First Line : 3288 BELVOIR BLVD
Second Line :
City : BEACHWOOD
State : OH
Zip : 44122-3831
Country : US
Telephone Number : 216-282-6786
Fax Number :
Provider Business Practice Location Address
First Line : 3783 GREEN RD
Second Line :
City : BEACHWOOD
State : OH
Zip : 44122-5705
Country : US
Telephone Number : 216-815-1810
Fax Number : 216-815-1811
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2009
Last Update Date : 07/21/2022

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