Jackelleyn R Mudd (NPI# 1609305580, PAC ID# 4688948979) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OPTOMETRY.
| Nation Provider ID (NPI) | 1609305580 |
| PAC ID by PECOS | 4688948979 |
| Professional Enrollment ID | I20170926001180 |
| Full Name | Jackelleyn R Mudd |
| Organization Legal Name | ADVANCED EYECARE OF WINFIELD LLC |
| Address |
102 Eagles Bluff Hts Winfield MO 63389-3453 |
| Phone Number | 6366686171 |
| Gender | F |
| Medical School | INDIANA UNIVERSITY - SCHOOL OF OPTOMETRY |
| Graduation Year | 2017 |
| Primary Specialty | OPTOMETRY |
| Group Practice PAC ID | 5799861639 |
| Number of Group Practice Members | 3 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 102 Eagles Bluff Hts, Winfield, MO 63389-3453 | 6366686171 | ADVANCED EYECARE OF WINFIELD LLC |
| Organization Legal Name | ADVANCED EYECARE OF WINFIELD LLC |
| Physicians | 2 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jessica M Downs | Optometry | Advanced Eyecare of Winfield LLC | 43 Ellis Ave, Troy, MO 63379-1151 |
| Street Address |
102 EAGLES BLUFF HTS |
| City | WINFIELD |
| State | MO |
| Zip | 63389-3453 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Rebecca D Taylor | Clinical Social Worker | 120 E Ave, 6 Familyz and Kidz Counseling, Winfield, MO 63389-3440 | |
| Robert Joseph Hammerling | Chiropractic | 10 Eagle Ave, Winfield, MO 63389-3441 | |
| Aleasha L Elliott | Nurse Practitioner | Mercy Hospital Lincoln | 35 Winfield Plz, Winfield, MO 63389-3451 |
| City | WINFIELD |
| Zip Code | 63389 |
| Specialty | OPTOMETRY |
| City + Specialty | WINFIELD + OPTOMETRY |
Please comment or provide details below to improve the information on Jackelleyn R Mudd.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.