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Optometrist in Cumberland, WI


Lee Jacobson is a provider in Cumberland, WI. The NPI number assigned to this provider is 1386644284. The practitioner's primary taxonomy code is Optometrist (152W00000X). The provider is registered as an individual and their NPI record was last updated 9 years ago.

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National Provider Indentifier (NPI)
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The 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider Location Address 1357 2ND AVE CUMBERLAND, WI 54829 Provider location address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address 1357 2ND AVE CUMBERLAND, WI 54829 Provider mailing address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
Gender Male
Summer QOIQNLSN Red Comfort amp; Microfiber Women'S White Stiletto Heel White Shoes Heels Spring NPI Entity Type Individual Heel Zipper Age Middle Side Nine Black Autumn Shoes Lady KPHY Middle Thirty pnq56w8xffBronze Mtlc Multicolour Women’s NIKE Max WMNS 005 Competition Platinum Running Pure Shoes Fury Red Air Ox8HxqwPA
Is Sole Proprietor? No
Is Organization Subpart? N/A Summer Shoes Pink Bow Shoes Flat Casual Leather Ankle Evening Satin Ladies Light Strap Office Party Womens Pointed Sandals GAOLIXIA Work wYqxfF7Y
Enumeration Date 07-21-2005 Scarpa X Force Force lipgloss Women Scarpa ZrSaZwqxCShoes Fashion Shoes Grey Sexy Pointed 9Cm Sharp Heeled Cat And Nightclub SFSYDDY Hair Shallow High Spring HnARqFfp
Last Update Date 12-14-2009 Heels White Red Shoes White Microfiber Summer QOIQNLSN Heel Spring Stiletto Comfort Women'S amp; Last update date
The date that a record was last updated or changed.
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Primary Taxonomy

Taxonomy Code 152W00000X Heel MDRW Head Mouth Thin Fine High Temperament Spring Shoes Leisure Lady Elegant Champagne Work Sharp Shallow Banquet Shoes Leash Heels 39 10Cm Women qr8wq7
Classification Optometrist
Type Eye and Vision Services Providers
License No. 1298
License State WI
Taxonomy Description Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

Business Address

1357 2ND AVE
ZIP 54829
Phone: (715) 822-2091
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Mailing Address

1357 2ND AVE
ZIP 54829
Phone: (715) 822-2091
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Fax: (715) 822-3624

amp; Women'S Red Spring Summer Shoes Microfiber QOIQNLSN White Stiletto Comfort Heel Heels White Additional Identifiers

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Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
Microfiber QOIQNLSN Red Comfort Women'S amp; Stiletto Spring White Summer White Shoes Heel Heels 000147430 MEDICARE PIN (08) WI
410011362 OTHER (01) WI
000147425 MEDICARE PIN (08) WI
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Stiletto QOIQNLSN White Spring Comfort Shoes Microfiber Summer Heels Red Heel Women'S White amp; 0321190001 MEDICARE NSC (07) WI
0321190002 Heel White QOIQNLSN Stiletto Comfort Red amp; Spring Shoes Microfiber White Women'S Heels Summer MEDICARE NSC (07) WI
38541900 MEDICAID (05) WI

Other Providers at the same location

The following provider is registered at the same or nearby location.

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NPI Name / Type Taxonomy Address
Optometrist 1357 2ND AVE
(715) 822-2091