Kohlhagen, Glen R
Kohlhagen, Glen R is an individual health care provider with primary practice located at 2414 Kohler Memorial Dr , Sheboygan WI 53081. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Kohlhagen, Glen R can be contacted via phone (920) 457-4461.Contact Information
Primary practice address
2414 Kohler Memorial Dr
Sheboygan WI 53081
Phone: (920) 457-4461
Fax: (920) 459-1483
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2276-035 | Wisconsin |
Profile Details
| NPI number | 1124135660 |
|---|---|
| LBN Legal business name | Kohlhagen, Glen R |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 23rd, 2006 |
| Last updated | Mar 7th, 2023 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124135660 | NPPES |
| Wisconsin | MEDICAID | 38576300 |
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