Individual
MARK H JEPPESEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2020 3RD AVE NW, WAVERLY, IA 50677-2065
(319) 352-3490
(319) 352-0468
Mailing address
2020 B 3RD AVE NW, WAVERLY, IA 50677
(319) 352-3490
(319) 352-0468
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
02199
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245969
—
IA
Enumeration date
08/17/2005
Last updated
05/13/2015
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