Provider Demographics
NPI:1295118677
Name:DORSEY, JILL (OD)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:DORSEY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1295 E 151ST ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-3406
Mailing Address - Country:US
Mailing Address - Phone:913-782-4983
Mailing Address - Fax:913-390-5663
Practice Address - Street 1:1295 E 151ST ST
Practice Address - Street 2:SUITE 3
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-3406
Practice Address - Country:US
Practice Address - Phone:913-782-4983
Practice Address - Fax:913-390-5663
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-03
Last Update Date:2015-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2003152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist