Raymond M Goga
Organization Active NPI Optometrist · Wittenberg, WI
NPI 1780748988 · NPPES record last updated Dec 18, 2009
Key facts
- NPI
- 1780748988
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- 1535 (WI)
- Legal business name
- RAYMOND M GOGA
- Practice address
- 601 S Webb St
Wittenberg, WI 54499-9042 - Phone
- (715) 253-2157
- Fax
- (715) 253-3457
- NPI assigned
- Dec 21, 2006
- Organization subpart
- No
Authorized official
- Name
- Sue Bushman
- Title
- Office Manager
- Phone
- (715) 253-2157
Practitioners 2
-
Erin Leigh Goga, O.D.
-
Ken Martell, OD
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | 1535 | WI | Yes |
Addresses
Primary practice location
601 S Webb St
Wittenberg, WI 54499-9042
Mailing address
601 S Webb St
Wittenberg, WI 54499-9042
Phone (715) 253-2157
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 38502100 | Medicaid | WI |
Other providers in Wittenberg, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 18, 2009. 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.