person
Charles Timothy Brakefield, OCULARIST
Ocularist in Madison, Wisconsin
NPI 1457894404

Charles Timothy Brakefield is a Ocularist based in Madison, WI and is specialized in Ocularist. Charles Timothy Brakefield practices in Madison, WI and has the professional credentials of OCULARIST. The NPI Number for Charles Timothy Brakefield is 1457894404 and holds a License No. 036-0002195093-04 (Wisconsin).

The current practice location address for Charles Timothy Brakefield is 6401 Odana Rd Ste 23, Madison, WI and can be reached out via phone at 608-661-9030 and via fax at 608-661-9040.

Location: 6401 Odana Rd Ste 23, Madison, WI, 53705-2288
person
Provider Profile Details
NPI Number
1457894404
Provider Name
Charles Timothy Brakefield
Credential
OCULARIST
Provider Entity Type
Individual
Gender
Male
Address
6401 Odana Rd Ste 23, Madison, WI, 53705-2288
Phone Number
608-661-9030
Fax Number
608-661-9040
Provider Enumeration Date
11/23/2016
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
41744100 05 WI
0829340001 01 WI MEDICARE PTAN
institution
Provider Business Practice Location Address Details
Address
6401 Odana Rd Ste 23
City
State
Zip
53719-1126
Phone Number
608-661-9030
Fax Number
608-661-9040
person
Provider Business Mailing Address Details
Address
6401 Odana Rd Ste 23
City
State
Zip
53719-1126
Phone Number
608-661-9030
Fax Number
608-661-9040
person
Provider's Taxonomy Details 1
Type
Eye and Vision Services Providers
Classification
Technician/Technologist
Speciality
Ocularist
Taxonomy
License No.
036-0002195093-04 (Wisconsin)
Definition
Definition to come...
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