Provider Demographics
NPI:1043293772
Name:FEULING, DANIEL L (OD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:L
Last Name:FEULING
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 N SPRING ST
Mailing Address - Street 2:
Mailing Address - City:BEAVER DAM
Mailing Address - State:WI
Mailing Address - Zip Code:53916-2115
Mailing Address - Country:US
Mailing Address - Phone:920-887-8831
Mailing Address - Fax:920-887-8862
Practice Address - Street 1:207 N SPRING ST
Practice Address - Street 2:
Practice Address - City:BEAVER DAM
Practice Address - State:WI
Practice Address - Zip Code:53916-2115
Practice Address - Country:US
Practice Address - Phone:920-887-8831
Practice Address - Fax:920-887-8862
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1621-035152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI0809570001OtherREGION B DMERC
WI511018OtherNVA
WI00009274OtherVCA
WIWI1621OtherECPA
WI5605OtherDAVIS VISION
WIW101621OtherVBA
WI38506200Medicaid
WI051001Other051001
WI1621-035OtherVSP
WIWI1621OtherEYEMED
WI1029530OtherPHYSICIANS PLUS
WI39130005OtherUNITY
WI391309995-01OtherJOHN DEERE HEALTH CARE
WI511018OtherNVA