Individual
JENNIFER FOGT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
338 W 10TH AVE, COLUMBUS, OH 43210-1280
(614) 292-2020
(614) 688-5603
Mailing address
338 W 10TH AVE, COLUMBUS, OH 43210-1280
(614) 292-2020
(614) 688-5603
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5033
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5033
OPTOMETRIC LICENSE
OH
Enumeration date
07/29/2005
Last updated
11/23/2016
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