MEDICARE: DR. LON C ARNESON 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
1	152W00000X	Optometrist	1522	WI

Other Identifiers

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

General Provider Information

NPI Number	:	1508846437
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LON C ARNESON OD

Provider Business Mailing Address
First Line	:	113 N BRIDGE ST
Second Line	:
City	:	CHIPPEWA FALLS
State	:	WI
Zip	:	54729-2404
Country	:	US
Telephone Number	:	715-723-9187
Fax Number	:	715-723-1755

Provider Business Practice Location Address
First Line	:	113 N BRIDGE ST
Second Line	:
City	:	CHIPPEWA FALLS
State	:	WI
Zip	:	54729-2404
Country	:	US
Telephone Number	:	715-723-9187
Fax Number	:	715-723-1755

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

Provider Enumeration Date	:	01/18/2006
Last Update Date	:	04/24/2008

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