Individual
DR. JACQUELYN GAYLE SHORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1001 S DEFIANCE ST, ARCHBOLD, OH 43502-1617
(419) 445-5436
(419) 446-4818
Mailing address
PO BOX 38, ARCHBOLD, OH 43502-0038
(419) 445-5436
(419) 446-4818
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3172
TN
152W00000X
Optometrist
Primary
7000
OH
152WC0802X
Corneal and Contact Management Optometrist
3172
TN
152WC0802X
Corneal and Contact Management Optometrist
7000
OH
152WL0500X
Low Vision Rehabilitation Optometrist
3172
TN
152WP0200X
Pediatric Optometrist
3172
TN
152WP0200X
Pediatric Optometrist
7000
OH
152WX0102X
Occupational Vision Optometrist
3172
TN
Other
Enumeration date
07/28/2014
Last updated
03/12/2026
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