Jacob G. Despain Od PC

NPI #1104237601 in Cody, Wyoming

Provider Information

NPI Number: 1104237601
Entity Type: Organization
Organization Name: Jacob G. Despain Od PC
Primary Specialty: Optometrist
Enumeration Date: May 19, 2014
Last Updated: May 19, 2014

Practice Location

Address: 1708 STAMPEDE AVE
City: Cody
State: Wyoming
ZIP Code: 82414-4829
Phone: (307) 587-2404

Authorized Official

Name: DR. JACOB G DESPAIN, O.D.
Title: OPTOMETRIST
Phone: (307) 587-2404

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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