Individual
MARK A KORNAUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1821 S STOUGHTON RD, MADISON, WI 53716-2257
(608) 260-6000
(608) 260-6716
Mailing address
1821 S STOUGHTON RD, DEAN MEDICAL CENTER, MADISON, WI 53716-2257
(608) 260-6000
(608) 260-6939
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2011-035
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1215993530
—
WI
Enumeration date
04/25/2006
Last updated
12/03/2020
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