Provider Demographics
NPI:1295734739
Name:HANDSCHUMACHER, JEFFREY D (OD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:D
Last Name:HANDSCHUMACHER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7500 RAMBLE WAY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-4307
Mailing Address - Country:US
Mailing Address - Phone:919-981-4444
Mailing Address - Fax:
Practice Address - Street 1:7500 RAMBLE WAY
Practice Address - Street 2:SUITE 101
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27616-4307
Practice Address - Country:US
Practice Address - Phone:919-981-4444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1708152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC4954450001OtherPALMETTO DMERC
NC4954450001OtherDMERC
NC890924WMedicaid
NCP00072370OtherRAIL ROAD MEDICARE
NCP00072370OtherRAIL ROAD MEDICARE
NC890924WMedicaid
NCU75674Medicare UPIN