Provider Demographics
NPI:1629417175
Name:HAYES, JESSICA COLPITT (OD)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:COLPITT
Last Name:HAYES
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:MARIE
Other - Last Name:COLPITT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:2000 S WHEELING AVE STE 1010
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-5646
Mailing Address - Country:US
Mailing Address - Phone:918-584-4433
Mailing Address - Fax:918-584-4479
Practice Address - Street 1:2000 S WHEELING AVE STE 1010
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-5646
Practice Address - Country:US
Practice Address - Phone:918-584-4433
Practice Address - Fax:918-584-4479
Is Sole Proprietor?:No
Enumeration Date:2013-06-18
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3096152W00000X, 152W00000X
OK2770152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
310504YQ5QMedicare PIN