Wallace, James Winchester

Wallace, James Winchester is an individual health care provider with primary practice located at 1450 E Geneva St , Delavan WI 53115-2025. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Wallace, James Winchester can be contacted via phone (262) 728-0068.

Contact Information

Primary practice address
1450 E Geneva St Delavan WI 53115-2025
Phone: (262) 728-0068
Fax: (262) 728-0055
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 2267 Wisconsin

Profile Details

NPI number 1285675827
LBN Legal business name Wallace, James Winchester
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 8th, 2006
Last updated Jul 8th, 2007 - about 18 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 1285675827 NPPES
Wisconsin MEDICAID 3857500

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