MEDICARE: DR. CHAD R OVERMAN O.D.

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	152WC0802X	Corneal and Contact Management Optometrist	2787	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	:	1982705810
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHAD R OVERMAN O.D.

Provider Business Mailing Address
First Line	:	PO BOX 212
Second Line	:
City	:	RICHLAND CENTER
State	:	WI
Zip	:	53581-0212
Country	:	US
Telephone Number	:	608-583-2756
Fax Number	:

Provider Business Practice Location Address
First Line	:	2401 HIGHWAY 14 EAST
Second Line	:
City	:	RICHLAND CENTER
State	:	WI
Zip	:	53581
Country	:	US
Telephone Number	:	608-647-7914
Fax Number	:

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

Provider Enumeration Date	:	09/25/2006
Last Update Date	:	07/08/2007

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