Individual
GREGORY JAMES SOVINSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1626 TUTTLE ST STE 1, BARABOO, WI 53913-1501
(608) 356-2020
(608) 355-7055
Mailing address
1626 TUTTLE ST STE 1, BARABOO, WI 53913-1501
(608) 356-2020
(608) 355-7055
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
74760-20
WI
390200000X
Student in an Organized Health Care Education/Training Program
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—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1841722451
—
WI
Enumeration date
04/02/2017
Last updated
07/27/2021
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