| Bruce M Koch, OD | |
|
1110 Prairie St, Prairie Du Sac, WI 53578-2044 | |
| (608) 643-3333 | |
| (608) 644-3852 |
| Full Name | Bruce M Koch |
|---|---|
| Gender | Male |
| Speciality | Optometrist |
| Location | 1110 Prairie St, Prairie Du Sac, Wisconsin |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720031529 | NPI | - | NPPES |
| 38567400 | Medicaid | WI | |
| 1006588 | Other | WI | PHYSICIANS PLUS |
| 947 | Other | WI | DEAN HEALTH INSURANCE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 1322-035 (Wisconsin) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Bruce M Koch, OD 1110 Prairie St, Prairie Du Sac, WI 53578-2044 Ph: (608) 643-3333 | Bruce M Koch, OD 1110 Prairie St, Prairie Du Sac, WI 53578-2044 Ph: (608) 643-3333 |
Gary J Lundgren, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 1110 Prairie St, Prairie Du Sac, WI 53578 Phone: 608-643-3333 Fax: 608-644-3852 | |
Julia M Dellaria-terrill, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 1110 Prairie St, Prairie Du Sac, WI 53578 Phone: 608-643-3333 Fax: 608-644-3852 |