IndividualActive
Jackson Fitzgerald, OD
NPI 1598495384 · Optometrist · Afton, WY
Provider details
- NPI number
- 1598495384
- Entity type
- Individual
- Primary specialty
- OptometristEye and Vision Services Providers
- Credential
- OD
- Sex
- Male
- Sole proprietor
- Yes
- License
- 548T (WY)
Specialties & taxonomies
Eye and Vision Services Providers
Eye and Vision Services Providers
Practice location
50 E 4th Ave
Afton, WY 83110-5027
Phone: (307) 885-3975
Approximate (ZIP-level) locationGet directions
Mailing address
4 S Hillside Dr
Elk Ridge, UT 84651-8501
Registry dates
- Enumerated
- 2022-06-14
- Last updated
- 2024-02-06
- Certified
- 2024-02-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.