Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. SALLY BETH JACKULA, OD
Active Sole ProprietorDR. SALLY BETH JACKULA, OD is a Optometrist healthcare provider located in SAINT CLOUD, Minnesota. NPI 1902804149 is currently active in the NPPES registry. Verify at CMS.
Optometrist · SAINT CLOUD, MN
Registration Details
- NPI Number
- 1902804149
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jul 12, 2005 (21.048973684875 yrs)
- Last Updated
- Mar 16, 2021
- License
-
2895 (MN)
- Sole Proprietor
- Yes
Practice Information
- Address
-
3112 SOUTHWAY DRSAINT CLOUD, MN, 563019589Browse MN providers · Browse ZIP 56301
- Phone
- 3202574747
- Fax
- 3202627118
- Primary Specialty
-
Optometrist
152W00000X
Other Optometrist Providers in SAINT CLOUD, MN
| Name | Credential | NPI |
|---|---|---|
| DR. ROBERT JACK JACKULA | OD | 1528066776 |
| JOHN G HASBROUCK | OD | 1225025927 |
| MICHAEL DAVID SUFKA | OD | 1083601165 |
| DR. MITCHELL DEAN HARSTAD | OD | 1396733143 |
| DR. DOUGLAS GROSS | O.D. | 1033193511 |
| MR. BRYAN DAVID LORENZ | OD | 1881634806 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.