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NPI Code Detail

MEDICARE: MCKENNA RAE YAHR OD

MEDICARE: MCKENNA RAE YAHR 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
1152W00000XOptometrist3918WI

General Provider Information

NPI Number : 1780379842
Entity Type Code : Individual
Provider Name (Legal Business Name) : MCKENNA RAE YAHR OD
Provider Business Mailing Address
First Line : 9000 W WISCONSIN AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53226-4874
Country : US
Telephone Number : 414-266-2020
Fax Number : 414-266-2027
Provider Business Practice Location Address
First Line : 9000 W WISCONSIN AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53226-4874
Country : US
Telephone Number : 414-266-2020
Fax Number : 414-266-2027
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2023
Last Update Date : 12/17/2025

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