Organization
BADGER VISION CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOEL D BAISDEN OD (DISREGARDED ENTITY)
(414) 453-7020
Entity
Organization
Contact information
Practice address
2505 N MAYFAIR RD, STE 100, WAUWATOSA, WI 53226-1404
(414) 453-7020
(414) 453-9980
Mailing address
2505 N MAYFAIR RD, STE 100, WAUWATOSA, WI 53226-1404
(414) 453-7020
(414) 453-9980
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2283
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4687710001
DME
WI
Enumeration date
12/09/2011
Last updated
03/07/2023
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