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Individual

DR. LEIF E ERICKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
15601 RAILROAD ST, SUITE 301, HAYWARD, WI 54843-6527
(715) 634-8616
Mailing address
15601 RAILROAD ST, SUITE 301, HAYWARD, WI 54843-6527
(715) 634-8616

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1306-035
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1001441
PREFERRED ONE
WI
01
11727
NVA & PROVANTAGE
WI
01
22-00507
MEDICA
WI
01
22704
SECURITY HEALTH
WI
05
26011R
WI
01
38568600
GROUP HEALTH
WI
05
38568600
WI
01
39-1131290
SELECT CARE & CBSA
WI
01
46988
HEALTH PARTNERS
WI
01
4U216ER
ATRIUM
WI
01
87213
TRI CARE
WI
05
87217
WI
Enumeration date
10/13/2006
Last updated
07/09/2007
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