Provider Demographics
NPI:1740436732
Name:HEGEWALD, JESSICA J (OD)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:J
Last Name:HEGEWALD
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:PO BOX 402
Mailing Address - Street 2:PMB 310
Mailing Address - City:DILLION
Mailing Address - State:CO
Mailing Address - Zip Code:80435
Mailing Address - Country:US
Mailing Address - Phone:970-368-6539
Mailing Address - Fax:970-368-6539
Practice Address - Street 1:358 BLUE RIVER PARKWAY
Practice Address - Street 2:SUITE D
Practice Address - City:SILVERTHORNE
Practice Address - State:CO
Practice Address - Zip Code:80498
Practice Address - Country:US
Practice Address - Phone:303-802-1022
Practice Address - Fax:303-802-1024
Is Sole Proprietor?:No
Enumeration Date:2008-08-11
Last Update Date:2018-03-17
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Provider Licenses
StateLicense IDTaxonomies
NM636152W00000X
CO2671152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist