Individual
JACLYN ELIZABETH DOFFIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
4750 WASHINGTON SQ, WHITE BEAR LAKE, MN 55110-3257
(651) 429-3379
(651) 429-8681
Mailing address
4750 WASHINGTON SQ, WHITE BEAR LAKE, MN 55110-3257
(651) 429-3379
(651) 429-8681
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2988
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1011968
PREFERRED ONE
MN
01
—
132424
UCARE
MN
01
—
2202621
MEDICA
MN
01
—
612R1ST
BLUE CROSS BLUE SHIELD
MN
05
—
869675600
—
MN
01
—
HP46401
HEALTH PARTNERS
MN
Enumeration date
05/09/2006
Last updated
05/21/2008
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