Schroder, John O

Schroder, John O is an individual health care provider with primary practice located at 205 Valley Ave , West Bend WI 53095-5312. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Schroder, John O can be contacted via phone (262) 338-1123.

Contact Information

Primary practice address
205 Valley Ave West Bend WI 53095-5312
Fax: (262) 338-7684
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 1552-035 Wisconsin

Profile Details

NPI number 1184731473
LBN Legal business name Schroder, John O
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 24th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184731473 NPPES
Wisconsin MEDICAID 38538500

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