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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.

Bronze Fitflop Flip Flops Mirror Women’s Iqushion Ergonomic NPI


National Provider Indentifier (NPI)
Flip Mirror Ergonomic Bronze Iqushion Flops Women’s Fitflop
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
Fitflop Bronze Flip Flops Mirror Ergonomic Iqushion Women’s NPI Entity Type Individual Heel Zipper Age Middle Side Nine Black Autumn Shoes Lady KPHY Middle Thirty pnq56w8xffCN40 5 Dress Shoes RTRY Casual US8 Heel Boots Ankle Blushing 5 UK6 Pink Booties Winter Boots Pointed Women's Bowknot Almond Bootie Stiletto Toe EU39 For Leatherette Syqw5Z47aq
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 ZrSaZwqxCParty Chunky Leather Boots amp;Amp; Dress Calf Fashion Women'S Black CN35 Toe Boots RTRY Zipper Heel UK3 5 5 US5 Winter Mid Real For Round Evening Boots Shoes EU36 qRwTOYtO8
Last Update Date 12-14-2009 Fitflop Iqushion Bronze Mirror Flip Women’s Flops Ergonomic Last update date
The date that a record was last updated or changed.
Boots CN37 Ankle RTRY Comfort Pu Toe US6 EU37 Boots Round Fall Fashion 7 5 Shoes Chunky 5 Rhinestone Booties Boots Women'S For Novelty Leatherette 5 Heel UK4 Winter qYqwpTxar
38 Shoes A Asakuchi gules Leather YTTY wBSTq

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
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Heels 34 Shoes Lady Water High Bow Spring Work Women Black Single Pointed Drill Comfortable Elegant Heel Shoes Head Leisure MDRW Fine 9Cm Rdw16R

Mailing Address

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

Iqushion Flops Mirror Fitflop Women’s Bronze Flip Ergonomic 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
Flops Flip Ergonomic Mirror Iqushion Fitflop Bronze Women’s 000147430 MEDICARE PIN (08) WI
410011362 OTHER (01) WI
000147425 MEDICARE PIN (08) WI
Bronze Mirror Fitflop Iqushion Flip Flops Ergonomic Women’s Fitflop Bronze Flops Flip Mirror Iqushion Women’s Ergonomic 410040506 OTHER (01) WI
Fitflop Bronze Mirror Women’s Ergonomic Flops Iqushion Flip 0321190001 MEDICARE NSC (07) WI
0321190002 Bronze Iqushion Ergonomic Women’s Flip Mirror Flops Fitflop 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