Provider Demographics
NPI:1578793626
Name:ZWANZIGER, JESSICA FIELDING (OD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:FIELDING
Last Name:ZWANZIGER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2013 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CUSHING
Mailing Address - State:OK
Mailing Address - Zip Code:74023-2910
Mailing Address - Country:US
Mailing Address - Phone:918-225-5565
Mailing Address - Fax:918-225-5656
Practice Address - Street 1:2013 E MAIN ST
Practice Address - Street 2:
Practice Address - City:CUSHING
Practice Address - State:OK
Practice Address - Zip Code:74023-2910
Practice Address - Country:US
Practice Address - Phone:918-225-5565
Practice Address - Fax:918-225-5656
Is Sole Proprietor?:No
Enumeration Date:2009-07-23
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2631152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist