Doffin, Jaclyn Elizabeth

Doffin, Jaclyn Elizabeth is an individual health care provider with primary practice located at 4750 Washington Sq , White Bear Lake MN 55110-3257. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Doffin, Jaclyn Elizabeth can be contacted via phone (651) 429-3379.

Contact Information

Primary practice address
4750 Washington Sq White Bear Lake MN 55110-3257
Phone: (651) 429-3379
Fax: (651) 429-8681
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 2988 Minnesota

Profile Details

NPI number 1053360701
LBN Legal business name Doffin, Jaclyn Elizabeth
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 9th, 2006
Last updated May 21st, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053360701 NPPES
Minnesota Other 132424 UCARE
Minnesota Other 2202621 UCARE
Minnesota MEDICAID 869675600 UCARE
Minnesota Other HP46401 UCARE
Minnesota Other 1011968 UCARE
Minnesota Other 612R1ST UCARE

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