Provider Demographics
NPI:1770619660
Name:LOOKHART, JEFF LEROY (OD)
Entity type:Individual
Prefix:DR
First Name:JEFF
Middle Name:LEROY
Last Name:LOOKHART
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:9504 TIMBER MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64086-9502
Mailing Address - Country:US
Mailing Address - Phone:816-347-9347
Mailing Address - Fax:816-795-9422
Practice Address - Street 1:2086 INDEPENDENCE CENTER DR
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64057
Practice Address - Country:US
Practice Address - Phone:816-795-7774
Practice Address - Fax:816-795-9422
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2001001861152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist