National Provider Identifier Database

BRODHEAD VISION CLINIC INC
Optometrist

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye.


Contact Information

BRODHEAD VISION CLINIC, INC
1005 17TH STREET
BRODHEAD, WI53520
Phone: 608-897-2128
Fax: 608-897-3937
Website:
Specialty Taxonomy Code
* Optometrist 152W00000X

* Indicates primary specialty

NPI Profile & details for BRODHEAD VISION CLINIC, INC

NPI Number 1164416236
Legal business name
LBN
BRODHEAD VISION CLINIC, INC
Authorized official DOUGLAS KELLEY - (OWNER/OD)
Entity Organization
Organization subpart No
Enumeration date 09/06/2005
Last updated 10/08/2014 - About 12 years ago
Sole proprietor1 Not specified
Identifiers
  • WI License #: 1483-035
  • WI Medicaid: 38545800
  • WI Other: PHYSICIANS PLUS 1006622
  • WI Other: RAILROAD MEDICARE 410035917
  • WI Other: MERCYCARE PRUDHGEN

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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