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Contact Information

JODI A BERGSTROM, OD
416 SUPERIOR AVENUE
CENTURIA, WI54824
 Phone: 715-646-1336
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for JODI A BERGSTROM · (Female)

NPI # 1568511095
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 01/10/2007
Last updated 12/12/2024 - More than a year ago
Sole proprietor 1 No
Identifiers
  • FL License # TPOP218
  • MD License # 3054
  • MI License # 4901005835
  • MN License # 2231
  • NE License # 1643
  • WI License # 2281
  • WI Medicaid 38594500
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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