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Individual

DR. JACOB L SCHOENENBERGER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
114 SOUTH MADISON ST, EVANSVILLE, WI 53536-1320
(608) 882-4990
(608) 882-3980
Mailing address
114 SOUTH MADISON ST, EVANSVILLE, WI 53536-1320
(608) 882-4990
(608) 882-3980

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
2327
WI
152W00000X
Optometrist
Primary
2327035
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
38578400
WI
Enumeration date
10/17/2005
Last updated
11/14/2012
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