Provider Demographics
NPI:1073752150
Name:JAGERMAN, LOUIS STEPHEN (MD)
Entity Type:Individual
Prefix:MR
First Name:LOUIS
Middle Name:STEPHEN
Last Name:JAGERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2729 CODY CIRCLE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-8281
Mailing Address - Country:US
Mailing Address - Phone:360-201-8313
Mailing Address - Fax:360-647-8486
Practice Address - Street 1:2729 CODY CIRCLE
Practice Address - Street 2:SUITE 102
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-8281
Practice Address - Country:US
Practice Address - Phone:360-201-8313
Practice Address - Fax:360-647-8486
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-12
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00030974207W00000X
CAG13257207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A38918Medicare UPIN