Provider Demographics
NPI:1245469154
Name:PASKIET, JACLYN M (OD)
Entity type:Individual
Prefix:DR
First Name:JACLYN
Middle Name:M
Last Name:PASKIET
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 207170
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75320-7170
Mailing Address - Country:US
Mailing Address - Phone:636-200-4393
Mailing Address - Fax:636-527-0766
Practice Address - Street 1:5081 N HAMILTON RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43230-8001
Practice Address - Country:US
Practice Address - Phone:614-473-9899
Practice Address - Fax:614-473-9906
Is Sole Proprietor?:No
Enumeration Date:2009-07-13
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5887152W00000X
OHOPT.005887152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH118392Medicare PIN
OH118393Medicare PIN