1588633044 NPI number — DAVIS, NELSON AND ASSOCIATES, INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588633044 NPI number — DAVIS, NELSON AND ASSOCIATES, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DAVIS, NELSON AND ASSOCIATES, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
EYE CONTACT
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1588633044
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7428 MINERAL POINT RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MADISON
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
53717-1710
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
608-833-4242
Provider Business Mailing Address Fax Number:
608-833-4248

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7428 MINERAL POINT RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MADISON
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53717-1710
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
608-833-4242
Provider Business Practice Location Address Fax Number:
608-833-4248
Provider Enumeration Date:
03/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
NELSON
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
WADE
Authorized Official Title or Position:
OPTOMETRIST
Authorized Official Telephone Number:
608-833-4242

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  2097 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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