Provider Demographics
NPI:1700804705
Name:ROWSON, JODI LYNN (OD)
Entity Type:Individual
Prefix:DR
First Name:JODI
Middle Name:LYNN
Last Name:ROWSON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:652 GREAT NORTHERN MALL
Mailing Address - Street 2:
Mailing Address - City:NORTH OLMSTED
Mailing Address - State:OH
Mailing Address - Zip Code:44070-3306
Mailing Address - Country:US
Mailing Address - Phone:440-734-5037
Mailing Address - Fax:440-734-0527
Practice Address - Street 1:652 GREAT NORTHERN MALL
Practice Address - Street 2:
Practice Address - City:NORTH OLMSTED
Practice Address - State:OH
Practice Address - Zip Code:44070-3306
Practice Address - Country:US
Practice Address - Phone:440-734-5037
Practice Address - Fax:440-734-0527
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4227 - T225152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2382425Medicaid
OH2382425Medicaid
OH0678464Medicare PIN