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General NPI Number Information
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NPI Number | 1851499313
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Entity Type | Organization
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Legal Business Name | BRANDON EYES, INC.
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 8406 OLD SAUK RD
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City | MIDDLETON
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State | WI
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Zip | 53562-4367
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Country | US
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Telephone | 608-833-7256
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Fax |
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Provider Business Mailing Address
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Address Line | 8406 OLD SAUK RD
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City | MIDDLETON
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State | WI
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Zip | 53562-4367
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Country | US
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Telephone | 608-833-7256
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. NORMAN ALAN BRANDON
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Credential | O.D.
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Telephone | 608-833-7256
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2779-035
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License Number State | WI
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