| Doctor Name: | MARK H JEPPESEN |
| NPI Number: | 1033101845 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | OD |
| License Number: | 02199 |
| Business Practice Address: | 2020 3rd Ave Nw Waverly, IA - 506772065 |
| Business Phone Number: | 3193523490 |
| Business Fax Number: | 3193520468 |
| Mailing Address: | 2020 B 3rd Ave Nw, WAVERLY |
| State: | IA |
| Postal Code: | 50677 |
| Phone Number: | 3193523490 |
| Fax Number: | 3193520468 |
| NPI Enumeration Date: | 08/17/2005 |
| NPI Last Update Date: | 05/13/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 152WC0802X |
| License Number: | 02199 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IA |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Optometrist |
| Taxonomy Specialization: | Corneal and Contact Management |
| Taxonomy Definition: | The professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea |