James L Forsythe, OD
Individual provider Active NPI Optometrist · Wisconsin Dells, WI
NPI 1194778472 · NPPES record last updated Apr 29, 2014
Key facts
- NPI
- 1194778472
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 1775-035 (WI)
- Practice address
- 1302 Broadway
Wisconsin Dells, WI 53965-1358 - Phone
- (608) 254-8383
- Fax
- (608) 253-6223
- NPI assigned
- May 18, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1775-035 | WI | MD | Optometrist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1775-035 | WI | Yes |
Addresses
Primary practice location
1302 Broadway
Wisconsin Dells, WI 53965-1358
Mailing address
1302 Broadway
Wisconsin Dells, WI 53965-1358
Phone (608) 254-8383
Other providers in Wisconsin Dells, WI
- Diane Dobbs
- Karla Jean Donohue
- Renato T Faylona
- Diana Marshall Fedewa
- Duane Michael Fedewa
- Kenneth G Forsythe
- Katherine Gesteland
- Lara Nicole Ginter
- Susan Gorski
- Jeremy William Gross
All providers in Wisconsin Dells, WI · Optometrist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 29, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.