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1275020836

NPI Code Detail

MEDICARE: BRYCE JORDAN AUL MD

MEDICARE: BRYCE JORDAN AUL MD

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
1	207R00000X	Internal Medicine Physician	29273	MN
2	207W00000X	Ophthalmology Physician	65796	MN
3	207W00000X	Ophthalmology Physician	81408-20	WI

General Provider Information

NPI Number	:	1275020836
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRYCE JORDAN AUL MD

Provider Business Mailing Address
First Line	:	608 W BROWN ST
Second Line	:
City	:	WAUPUN
State	:	WI
Zip	:	53963-1788
Country	:	US
Telephone Number	:	920-926-8472
Fax Number	:

Provider Business Practice Location Address
First Line	:	608 W BROWN ST
Second Line	:
City	:	WAUPUN
State	:	WI
Zip	:	53963-1788
Country	:	US
Telephone Number	:	920-926-8472
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/19/2018
Last Update Date	:	01/10/2024

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Directions to “ BRYCE JORDAN AUL MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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