Vision Mart Inc | |
12000 W Carmen Ave, Milwaukee, WI 53225-2116 | |
(414) 462-1300 | |
Not Available |
Full Name | Vision Mart Inc |
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Type | Facility |
Speciality | Technician/technologist - Optician |
Location | 12000 W Carmen Ave, Milwaukee, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1366491227 | NPI | - | NPPES |
38450000 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Primary |
156FX1800X | Technician/technologist - Optician | (* (Not Available)) | Primary |
Provider Name | Paul R Herzfeld |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1417086901 PECOS PAC ID: 5799774329 Enrollment ID: I20040510000543 |
Provider Name | Kristopher T Knous |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1356432199 PECOS PAC ID: 9335036664 Enrollment ID: I20041214000667 |
Provider Name | Sara C Falter |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1265698187 PECOS PAC ID: 5395804389 Enrollment ID: I20081105000586 |
Provider Name | Robert M Blankenbehler |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1700034931 PECOS PAC ID: 7911066089 Enrollment ID: I20100917000624 |
Provider Name | Kurt A Haefs |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1578658068 PECOS PAC ID: 2062691918 Enrollment ID: I20110124001015 |
Provider Name | Jessica M Bisgrove |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1114213261 PECOS PAC ID: 3476721416 Enrollment ID: I20110719000490 |
Provider Name | Lisa M Peterson |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1881988244 PECOS PAC ID: 1658541339 Enrollment ID: I20110907001434 |
Provider Name | Yoseph Sarrafzadeh |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1265729222 PECOS PAC ID: 6002088044 Enrollment ID: I20111101000093 |
Provider Name | Michael Douglas Rickels |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1124332283 PECOS PAC ID: 1456521590 Enrollment ID: I20150915002147 |
Provider Name | Eric Tyler |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1285652826 PECOS PAC ID: 2668367897 Enrollment ID: I20160323000843 |
Provider Name | Ashley M Rak |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1497196059 PECOS PAC ID: 6709018286 Enrollment ID: I20160519001033 |
Provider Name | Alwin A Edakkunnathu |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1467899609 PECOS PAC ID: 8123250776 Enrollment ID: I20170804002374 |
Mailing Address | Practice Location Address |
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Vision Mart Inc 12000 W Carmen Ave, Milwaukee, WI 53225-2116 Ph: (414) 462-1300 | Vision Mart Inc 12000 W Carmen Ave, Milwaukee, WI 53225-2116 Ph: (414) 462-1300 |