Provider Demographics
NPI:1235184615
Name:RANSDELL, JASON TODD (OD)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:TODD
Last Name:RANSDELL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14269 N 87TH ST STE 203
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-3695
Mailing Address - Country:US
Mailing Address - Phone:480-483-8882
Mailing Address - Fax:
Practice Address - Street 1:7727 W DEER VALLEY RD
Practice Address - Street 2:SUITE E-2
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85382-2116
Practice Address - Country:US
Practice Address - Phone:623-376-9070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-23
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1277152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ0904740OtherBCBS
DN9981OtherMEDICARE RAILROAD
2Z1528OtherHEALTHNET
100044Medicare ID - Type Unspecified
DN9981OtherMEDICARE RAILROAD