Individual
JEFFERY J. SCHLETZBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2311 N WALDRON ST, HUTCHINSON, KS 67502-1133
(620) 663-4467
(620) 663-5007
Mailing address
2311 N WALDRON ST, HUTCHINSON, KS 67502-1133
(620) 663-4467
(620) 663-5007
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1663
KS
152WC0802X
Corneal and Contact Management Optometrist
1663
KS
152WP0200X
Pediatric Optometrist
1663
KS
152WS0006X
Sports Vision Optometrist
1663
KS
152WV0400X
Vision Therapy Optometrist
1663
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200252620A
—
KS
01
—
464910
KANSAS HEALTHWAVE
—
01
—
4901160002
DMERC
—
01
—
P00016824
RAILROAD MEDICARE
—
Enumeration date
03/16/2006
Last updated
07/23/2009
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