Provider Demographics
NPI:1235279019
Name:JEFFREY D. HIXENBAUGH, O.D., P.A.
Entity Type:Organization
Organization Name:JEFFREY D. HIXENBAUGH, O.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:DARRIN
Authorized Official - Last Name:HIXENBAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:561-627-8185
Mailing Address - Street 1:3101 PGA BLVD
Mailing Address - Street 2:SUITE A101
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-2820
Mailing Address - Country:US
Mailing Address - Phone:561-627-8185
Mailing Address - Fax:561-627-6456
Practice Address - Street 1:3101 PGA BLVD
Practice Address - Street 2:SUITE A101
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-2820
Practice Address - Country:US
Practice Address - Phone:561-627-8185
Practice Address - Fax:561-627-6456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2007-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC2588152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty