Provider Demographics
NPI:1447353867
Name:MARKSON, JEFFREY FORD (OD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:FORD
Last Name:MARKSON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 LONGHOUSE LN
Mailing Address - Street 2:
Mailing Address - City:SLINGERLANDS
Mailing Address - State:NY
Mailing Address - Zip Code:12159-3012
Mailing Address - Country:US
Mailing Address - Phone:518-452-9763
Mailing Address - Fax:
Practice Address - Street 1:141 WASHINGTON AVE EXT
Practice Address - Street 2:WALMART VISION CENTER
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203
Practice Address - Country:US
Practice Address - Phone:518-464-1804
Practice Address - Fax:518-464-0076
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYT-3998-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist