Provider Demographics
NPI:1386948669
Name:MCCOMAS, JAELYN (OD)
Entity type:Individual
Prefix:DR
First Name:JAELYN
Middle Name:
Last Name:MCCOMAS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9309 GLACIER HWY
Mailing Address - Street 2:SUITE A103
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801-9306
Mailing Address - Country:US
Mailing Address - Phone:907-988-5235
Mailing Address - Fax:
Practice Address - Street 1:9309 GLACIER HWY
Practice Address - Street 2:SUITE A103
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801-9306
Practice Address - Country:US
Practice Address - Phone:907-988-5235
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-31
Last Update Date:2010-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK301152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist