Individual
DR. JOEL D. BAISDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2505 N MAYFAIR RD, #100, WAUWATOSA, WI 53226-1404
(414) 453-7020
(414) 453-9980
Mailing address
1950 OLD GALLOWS RD STE 520, VIENNA, VA 22182-3970
(703) 847-8899
(571) 223-6780
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
12/14/2006
Last updated
03/07/2023
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