Provider Demographics
NPI:1427225838
Name:JARAD M. WAITE, OD, PA
Entity Type:Organization
Organization Name:JARAD M. WAITE, OD, PA
Other - Org Name:FAMILY EYE CARE OF ABILENE, PA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JARAD
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:WAITE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:785-263-2020
Mailing Address - Street 1:311 NW 3RD ST
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:KS
Mailing Address - Zip Code:67410
Mailing Address - Country:US
Mailing Address - Phone:785-263-2020
Mailing Address - Fax:785-263-1290
Practice Address - Street 1:311 NW 3RD ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:KS
Practice Address - Zip Code:67410-2632
Practice Address - Country:US
Practice Address - Phone:785-263-2020
Practice Address - Fax:785-263-1290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-14
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1667152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS1427225838OtherNPI
KS6161060001Medicare NSC