Provider Demographics
NPI:1417086752
Name:ADLER, BRIAN CHRISTOPHER (OD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:CHRISTOPHER
Last Name:ADLER
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 1:17550 W BLUEMOUND RD
Mailing Address - Street 2:D
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53045-2928
Mailing Address - Country:US
Mailing Address - Phone:262-784-3700
Mailing Address - Fax:
Practice Address - Street 1:17550 W BLUEMOUND RD
Practice Address - Street 2:D
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53045-2928
Practice Address - Country:US
Practice Address - Phone:262-784-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2940152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist