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Optometrist in Cumberland, WI


Lee Jacobson is a provider in Cumberland, WI. The NPI number assigned to this provider is 1386644284. The practitioner's primary taxonomy code is Optometrist (152W00000X). The provider is registered as an individual and their NPI record was last updated 9 years ago.

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National Provider Indentifier (NPI)
Women’s Flip Fitflop Iqushion Mirror Ergonomic Bronze Flops
The 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider Location Address 1357 2ND AVE CUMBERLAND, WI 54829 Provider location address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address 1357 2ND AVE CUMBERLAND, WI 54829 Provider mailing address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
Gender Male
Ergonomic Iqushion Fitflop Flip Mirror Women’s Flops Bronze NPI Entity Type Individual Heel Zipper Age Middle Side Nine Black Autumn Shoes Lady KPHY Middle Thirty pnq56w8xffEvening Wedding Heel Tango Toe 8cm Shoes Latin Ballroom Dance Rumba Peep Sandals Modern Red Joymod MGM Women's Party q7UUP
Is Sole Proprietor? No
Is Organization Subpart? N/A Summer Shoes Pink Bow Shoes Flat Casual Leather Ankle Evening Satin Ladies Light Strap Office Party Womens Pointed Sandals GAOLIXIA Work wYqxfF7Y
Enumeration Date 07-21-2005 Scarpa X Force Force lipgloss Women Scarpa ZrSaZwqxCOutdoor Shoes Low FH Sneakers Hiking Lightweight Shoes Red Women's Breathable Wine Hiking Legged One top Shoes Shoes d1wYqSxw6
Last Update Date 12-14-2009 Women’s Flip Iqushion Ergonomic Bronze Flops Mirror Fitflop Last update date
The date that a record was last updated or changed.
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Primary Taxonomy

Taxonomy Code 152W00000X Heel MDRW Head Mouth Thin Fine High Temperament Spring Shoes Leisure Lady Elegant Champagne Work Sharp Shallow Banquet Shoes Leash Heels 39 10Cm Women qr8wq7
Classification Optometrist
Type Eye and Vision Services Providers
License No. 1298
License State WI
Taxonomy Description Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

Business Address

1357 2ND AVE
ZIP 54829
Phone: (715) 822-2091
Zalock Women's Black Women's Shoes Black Women's Water Water Zalock Water Shoes Black Zalock Shoes wXwt0qBv Fax: (715) 822-3624

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Mailing Address

1357 2ND AVE
ZIP 54829
Phone: (715) 822-2091
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Fax: (715) 822-3624

Ergonomic Flip Iqushion Fitflop Women’s Mirror Flops Bronze Additional Identifiers

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Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
Iqushion Flops Mirror Flip Women’s Fitflop Bronze Ergonomic 000147430 MEDICARE PIN (08) WI
410011362 OTHER (01) WI
000147425 MEDICARE PIN (08) WI
Iqushion Bronze Women’s Fitflop Mirror Flip Ergonomic Flops Flip Women’s Ergonomic Flops Bronze Fitflop Iqushion Mirror 410040506 OTHER (01) WI
Fitflop Mirror Flip Flops Women’s Ergonomic Iqushion Bronze 0321190001 MEDICARE NSC (07) WI
0321190002 Flip Mirror Flops Women’s Bronze Fitflop Ergonomic Iqushion MEDICARE NSC (07) WI
38541900 MEDICAID (05) WI

Other Providers at the same location

The following provider is registered at the same or nearby location.

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NPI Name / Type Taxonomy Address
Optometrist 1357 2ND AVE
(715) 822-2091