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Contact Information

JASON C KOSCHMEDER, OD
5200 EUBANK BLVD NE
SUITE A-4
ALBUQUERQUE, NM87111-1759
 Phone: 505-298-4419
 Fax: 505-298-0878
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for JASON C KOSCHMEDER · (Male)

NPI # 1083040547
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 09/16/2013
Last updated 12/05/2014 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • NM License # 660
  • NM Medicaid 78880386
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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