Individual
DR. JENNIFER L SAMUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
940 N SWITZER CYN DR, #101, FLAGSTAFF, AZ 86001-4852
(928) 774-7949
(928) 774-7207
Mailing address
940 N SWITZER CYN DR, #101, FLAGSTAFF, AZ 86001-4852
(928) 774-7949
(928) 774-7207
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1263
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
48524047
MEDICAID
NM
05
—
790677
—
AZ
01
—
D00087920
RAILROAD
AZ
Enumeration date
10/25/2005
Last updated
03/14/2008
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