Provider Demographics
NPI:1326619982
Name:NEWLAND, JEFFREY MICHAEL (OD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:MICHAEL
Last Name:NEWLAND
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:1212 PLEASANT STREET
Mailing Address - Street 2:SUITE 202
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-1411
Mailing Address - Country:US
Mailing Address - Phone:515-244-3937
Mailing Address - Fax:515-243-1442
Practice Address - Street 1:1212 PLEASANT STREET
Practice Address - Street 2:SUITE 202
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-1411
Practice Address - Country:US
Practice Address - Phone:515-244-3937
Practice Address - Fax:515-243-1442
Is Sole Proprietor?:No
Enumeration Date:2021-07-06
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA109201152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist