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NPI Code Detail

MEDICARE: 1 VISION S.C.

MEDICARE: 1 VISION S.C.
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
1152W00000XOptometrist2324WI

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1410033786OTHERWIRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1033197397
Entity Type Code : Organization
Provider Name (Legal Business Name) : 1 VISION S.C.
Provider Business Mailing Address
First Line : PO BOX 513
Second Line :
City : SHAWANO
State : WI
Zip : 54166-0513
Country : US
Telephone Number : 715-526-3163
Fax Number : 715-526-4019
Provider Business Practice Location Address
First Line : 150A COUNTY RD B
Second Line :
City : SHAWANO
State : WI
Zip : 54166-7072
Country : US
Telephone Number : 715-526-3163
Fax Number : 715-526-4019
Authorized Official
Title or Position : O.D. - PRESIDENT
Name : MR. THOMAS G PETERSON
Credential : O.D.
Telephone Number : 715-526-3163
Provider Enumeration Date : 01/06/2006
Last Update Date : 05/17/2022

Similar Medicare Providers

1548260839 — THEDACARE MEDICAL CENTER - SHAWANO, INC.
Practice Location Address:
100 COUNTY ROAD B
SHAWANO, WI
54166-7072
Practice Phone: 715-526-2111
Practice Fax: 715-526-7308
1679561039 — MEGHAN L GALLAGHER M.S.-CCC.SLP
Practice Location Address:
100 COUNTY ROAD B
SHAWANO, WI
54166-7072
Practice Phone: 715-526-2111
Practice Fax:
1497745715 — ANN M TOUSIGNANT MD
Practice Location Address:
100 COUNTY ROAD B
SHAWANO, WI
54166-7072
Practice Phone: 715-524-2161
Practice Fax: 715-524-8164
1699766766 — DR. WILLIAM D. HAMPTON D.O.
Practice Location Address:
100 COUNTY ROAD B
SHAWANO, WI
54166-7072
Practice Phone: 715-526-2111
Practice Fax:
1770560278 — WILLIAM T KUMPREY MD
Practice Location Address:
100 COUNTY ROAD B
SHAWANO, WI
54166-7072
Practice Phone: 715-526-2111
Practice Fax:
1548248313 — THEDACARE MEDICAL CENTER - SHAWANO, INC.
Practice Location Address:
100 COUNTY ROAD B
SHAWANO, WI
54166-7072
Practice Phone: 715-524-2169
Practice Fax: 715-526-7140

Directions to “1 VISION S.C. ” Practice Location

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