Provider Demographics
NPI:1639325780
Name:SLOTWINSKI, JENNIFER G (OD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:G
Last Name:SLOTWINSKI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:G
Other - Last Name:KOLODZIEJCZYK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:5524 BRENDLYNN DR
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-7553
Mailing Address - Country:US
Mailing Address - Phone:630-269-0760
Mailing Address - Fax:
Practice Address - Street 1:3085 BUFORD HWY
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-3353
Practice Address - Country:US
Practice Address - Phone:770-476-3611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-08
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT003224152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist