Provider Demographics
NPI:1083995708
Name:JEFFREY J.EGER,OD PC.
Entity Type:Organization
Organization Name:JEFFREY J.EGER,OD PC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:JOEL
Authorized Official - Last Name:EGER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:480-964-6672
Mailing Address - Street 1:1106 W UNIVERSITY DR
Mailing Address - Street 2:#1
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85201-5532
Mailing Address - Country:US
Mailing Address - Phone:480-964-6672
Mailing Address - Fax:
Practice Address - Street 1:1106 W UNIVERSITY DR
Practice Address - Street 2:#1
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85201-5532
Practice Address - Country:US
Practice Address - Phone:480-964-6672
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-08
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ51152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty