Individual
MR. NATHAN KARL EICHHORST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
130 WALNUT STREET, SPOONER, WI 54801-1319
(715) 635-2020
(715) 635-2956
Mailing address
130 WALNUT STREET, SPOONER, WI 54801-1319
(715) 635-2020
(715) 635-2956
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2293035
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2200142
MEDICA
—
05
—
38584900
—
WI
01
—
391818241013
BLUE CROSS BLUE SHIELD
—
Enumeration date
03/08/2006
Last updated
03/02/2010
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