Individual
DR. JEFF BANAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
3805B SPRING ST STE 140, MOUNT PLEASANT, WI 53405-1642
(262) 637-0500
(262) 635-8027
Mailing address
3805B SPRING ST STE 140, MOUNT PLEASANT, WI 53405-1642
(262) 637-0500
(262) 635-8027
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3424
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100074192
—
WI
Enumeration date
06/30/2016
Last updated
01/09/2024
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