Dr Dennis Raymond Soderberg, OD is a
Optometrist based in Baldwin, Wisconsin. Dr Dennis Raymond Soderberg is licensed to practice in Wisconsin (license number 1396) and his current practice location is
1620 10th Ave, Baldwin, Wisconsin. He can be reached at his office (for appointments etc.) via phone at
(715) 684-3310.
NPI number for Dr Dennis Raymond Soderberg is 1649235524 and his current mailing address is 1620 10th Ave, Baldwin, Wisconsin. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1649235524.
Healthcare Provider's Profile
| Full Name | Dr Dennis Raymond Soderberg |
|---|
| Gender | Male |
|---|
| Speciality | Optometrist |
|---|
| Location | 1620 10th Ave, Baldwin, Wisconsin |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1649235524
- Provider Enumeration Date: 04/20/2006
- Last Update Date: 07/09/2007
Medical Identifiers
Medical identifiers for Dr Dennis Raymond Soderberg such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1649235524 | NPI | - | NPPES |
| 391170106044 | Other | WI | CLAIMS MANAGEMENT |
| 391170106036 | Other | WI | COMPCARE |
| 22-12358 | Other | | MEDICA |
| 38411800 | Medicaid | WI | |
| 391170106028 | Other | WI | BCBS |
| 774002 | Other | | PREFERRED ONE |
| 795000 | Other | | HEALTH PARTNERS |
| 92530S0 | Other | MN | BCBS |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 152W00000X | Optometrist | 1396 (Wisconsin) | Primary |
| 152W00000X | Optometrist | 1549 (Minnesota) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Dennis Raymond Soderberg is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Dennis Raymond Soderberg, OD
1620 10th Ave,
Baldwin, WI 54002-9033
Ph: (715) 684-3310 | Dr Dennis Raymond Soderberg, OD
1620 10th Ave,
Baldwin, WI 54002-9033
Ph: (715) 684-3310 |
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