Provider Demographics
NPI:1811200819
Name:KUCHERA, FRANCIS JARED (OD)
Entity Type:Individual
Prefix:DR
First Name:FRANCIS
Middle Name:JARED
Last Name:KUCHERA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:DR
Other - First Name:FRANK
Other - Middle Name:
Other - Last Name:KUCHERA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:1381 S PATRICK DR
Mailing Address - Street 2:
Mailing Address - City:PATRICK AFB
Mailing Address - State:FL
Mailing Address - Zip Code:32925-3606
Mailing Address - Country:US
Mailing Address - Phone:321-494-8164
Mailing Address - Fax:321-494-8533
Practice Address - Street 1:1381 S PATRICK DR
Practice Address - Street 2:
Practice Address - City:PATRICK AFB
Practice Address - State:FL
Practice Address - Zip Code:32925-3606
Practice Address - Country:US
Practice Address - Phone:321-494-8164
Practice Address - Fax:321-494-8533
Is Sole Proprietor?:No
Enumeration Date:2010-07-19
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1764152W00000X
OR3361ATI152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist