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NPI Code Detail

MEDICARE: DR. BLADE ARON GRUPE OD

MEDICARE: DR. BLADE ARON GRUPE OD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometristOEG003891PA
2390200000XStudent in an Organized Health Care Education/Training Program
3152W00000XOptometrist3984WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1023761103
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BLADE ARON GRUPE OD
Provider Business Mailing Address
First Line : 118 S CHURCH ST
Second Line :
City : ALMA CENTER
State : WI
Zip : 54611-7711
Country : US
Telephone Number : 715-896-5626
Fax Number :
Provider Business Practice Location Address
First Line : 1626 TUTTLE ST STE 1
Second Line :
City : BARABOO
State : WI
Zip : 53913-1501
Country : US
Telephone Number : 608-356-2020
Fax Number : 608-355-7055
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2022
Last Update Date : 09/19/2024

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Directions to “ DR. BLADE ARON GRUPE OD” Practice Location

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