James Kent Degener, O.D.
Individual provider Active NPI Optometrist · Baraboo, WI
NPI 1447355227 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1447355227
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 1462 (WI)
- Practice address
- 920 Highway 12
Baraboo, WI 53913 - Phone
- (608) 356-6276
- NPI assigned
- Sep 14, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1462 | WI | Yes |
Addresses
Primary practice location
920 Highway 12
Baraboo, WI 53913
Mailing address
20908 County Highway T
Norwalk, WI 54648-8016
Phone (608) 343-0926
Other providers in Baraboo, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.