Provider Demographics
NPI:1225479447
Name:RUNKEL, JULIA (OD)
Entity Type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:
Last Name:RUNKEL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:MISS
Other - First Name:JULIA
Other - Middle Name:
Other - Last Name:SCHRAMMEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:642 ORION TRL
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53718-2926
Mailing Address - Country:US
Mailing Address - Phone:714-732-2795
Mailing Address - Fax:
Practice Address - Street 1:29 E TOWNE MALL
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53704-3711
Practice Address - Country:US
Practice Address - Phone:608-246-0308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-16
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3314-35152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist