Dr Kimberly Dawn Jedlicka, OD is a
Optometrist based in Jordan, Minnesota. Dr Kimberly Dawn Jedlicka is licensed to practice in Minnesota (license number 2632) and her current practice location is
223 1st St E, Suite 101, Jordan, Minnesota. She can be reached at her office (for appointments etc.) via phone at
(952) 492-2350.
NPI number for Dr Kimberly Dawn Jedlicka is 1790817203 and her current mailing address is 830 Dakota Pt, Jordan, Minnesota. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1790817203.
Healthcare Provider's Profile
| Full Name | Dr Kimberly Dawn Jedlicka |
|---|
| Gender | Female |
|---|
| Speciality | Optometrist |
|---|
| Location | 223 1st St E, Jordan, Minnesota |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1790817203
- Provider Enumeration Date: 03/10/2007
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Dr Kimberly Dawn Jedlicka such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1790817203 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 152W00000X | Optometrist | 2632 (Minnesota) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Kimberly Dawn Jedlicka is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Kimberly Dawn Jedlicka, OD
830 Dakota Pt,
Jordan, MN 55352-1441
Ph: (952) 492-3135 | Dr Kimberly Dawn Jedlicka, OD
223 1st St E, Suite 101,
Jordan, MN 55352-1561
Ph: (952) 492-2350 |
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