Individual
DR. RICHARD DAVISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
4301 W WISCONSIN AVE, APPLETON, WI 54913-8605
(920) 731-6116
(920) 731-6119
Mailing address
4301 W WISCONSIN AVE, APPLETON, WI 54913-8605
(920) 731-6116
(920) 731-6119
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1993
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39788727
TAX ID
WI
Enumeration date
11/07/2006
Last updated
07/08/2007
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