David W. Kisiolek, O.d., S.c. | |
300 Audubon Rd, Howards Grove, WI 53083-1280 | |
(920) 565-3991 | |
(920) 565-4404 |
Full Name | David W. Kisiolek, O.d., S.c. |
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Type | Facility |
Speciality | Optometrist |
Location | 300 Audubon Rd, Howards Grove, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1619065224 | NPI | - | NPPES |
38514400 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 1742 (Wisconsin) | Primary |
Provider Name | David W Kisiolek |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1285748459 PECOS PAC ID: 1759388028 Enrollment ID: I20070418000130 |
Provider Name | Kristie L Andrews |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1073996633 PECOS PAC ID: 5991006405 Enrollment ID: I20151228001844 |
Mailing Address | Practice Location Address |
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David W. Kisiolek, O.d., S.c. 300 Audubon Rd, Howards Grove, WI 53083-1280 Ph: (920) 565-3991 | David W. Kisiolek, O.d., S.c. 300 Audubon Rd, Howards Grove, WI 53083-1280 Ph: (920) 565-3991 |
Dr. Kristie Lynn Andrews, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 300 Audubon Rd, Howards Grove, WI 53083 Phone: 920-565-3991 | |
David W Kisiolek, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 300 Audubon Rd, Howards Grove, WI 53083 Phone: 920-565-3991 Fax: 920-565-4404 |