Wild, Randy Joseph

Wild, Randy Joseph is an sole proprietor health care provider with primary practice located at 1111 Maple St , Neenah WI 54956-4122. He recently has 6 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Pediatrics, Eye and Vision Services Providers / Sports Vision, Eye and Vision Services Providers / Vision Therapy, Eye and Vision Services Providers / Occupational Vision. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Wild, Randy Joseph can be contacted via phone (920) 722-7411.

Contact Information

Primary practice address
1111 Maple St Neenah WI 54956-4122
Fax:
Website:

Health care specialties

Profile Details

NPI number 1891812749
LBN Legal business name Wild, Randy Joseph
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 24th, 2007
Last updated Jun 6th, 2008 - about 16 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 1891812749 NPPES
Wisconsin MEDICAID 38509100

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