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General NPI Number Information
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NPI Number | 1871769646
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Entity Type | Organization
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Legal Business Name | JOHN W. SCHAEFER, O.D.
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Dates
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Enumeration Date | 05/01/2008
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Last Update Date | 09/23/2008
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Provider Practice Location Address
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Address Line | 205 DIVISION ST.
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City | MAUSTON
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State | WI
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Zip | 53948-2109
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Country | US
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Telephone | 608-847-6264
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Fax | 608-847-7279
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Provider Business Mailing Address
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Address Line | 205 DIVISION ST.
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City | MAUSTON
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State | WI
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Zip | 53948-2109
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Country | US
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Telephone | 608-847-6264
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Fax | 608-847-7279
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN W. SCHAEFER
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Credential | O.D.
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Telephone | 608-847-6264
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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 | 1761
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License Number State | WI
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