Mergenthaler, Mathew Bryan

Mergenthaler, Mathew Bryan is an individual health care provider with primary practice located at 309 E Broadway Ave , Medford WI 54451-1835. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Mergenthaler, Mathew Bryan can be contacted via phone (715) 748-2020.

Contact Information

Primary practice address
309 E Broadway Ave Medford WI 54451-1835
Phone: (715) 748-2020
Fax: (715) 748-2020
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 073539 Iowa
Eye and Vision Services Providers / Optometrist 152W00000X 3359 Wisconsin

Profile Details

NPI number 1568874907
LBN Legal business name Mergenthaler, Mathew Bryan
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 20th, 2014
Last updated May 9th, 2019 - about 5 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 1568874907 NPPES
Wisconsin MEDICAID 100039841

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