Swanson, Eugene M
Swanson, Eugene M is an sole proprietor health care provider with primary practice located at 207 N Spring St , Beaver Dam WI 53916-2115. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Swanson, Eugene M can be contacted via phone (920) 887-8831.Contact Information
Primary practice address
207 N Spring St
Beaver Dam WI 53916-2115
Phone: (920) 887-8831
Fax: (920) 887-8862
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2718 | Minnesota |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 3067-035 | Wisconsin |
Profile Details
| NPI number | 1316919590 |
|---|---|
| LBN Legal business name | Swanson, Eugene M |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 2nd, 2006 |
| Last updated | Feb 2nd, 2010 - about 14 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 | 1316919590 | NPPES |
| Wisconsin | MEDICAID | 38631900 | |
| Wisconsin | MEDICAID | 490690000 |
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