Individual
RICHARD DANE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1 S PARK ST, MADISON, WI 53715-1375
(608) 916-2020
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3680-35
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1215516646
—
WI
Enumeration date
04/04/2021
Last updated
05/04/2026
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