James, Mark E.

James, Mark E. is an individual health care provider with primary practice located at 822 Park Ave , Beaver Dam WI 53916-2266. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. James, Mark E. can be contacted via phone (920) 887-3791.

Contact Information

Primary practice address
822 Park Ave Beaver Dam WI 53916-2266
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 2181 Wisconsin

Profile Details

NPI number 1992747745
LBN Legal business name James, Mark E.
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 12th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992747745 NPPES
Wisconsin MEDICAID 38422300

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