Provider Demographics
NPI:1508846437
Name:ARNESON, LON C (OD)
Entity Type:Individual
Prefix:DR
First Name:LON
Middle Name:C
Last Name:ARNESON
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 1:113 N BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:CHIPPEWA FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54729-2404
Mailing Address - Country:US
Mailing Address - Phone:715-723-9187
Mailing Address - Fax:715-723-1755
Practice Address - Street 1:113 N BRIDGE ST
Practice Address - Street 2:
Practice Address - City:CHIPPEWA FALLS
Practice Address - State:WI
Practice Address - Zip Code:54729-2404
Practice Address - Country:US
Practice Address - Phone:715-723-9187
Practice Address - Fax:715-723-1755
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1522152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38515500Medicaid
00004718Z0001Medicare ID - Type Unspecified
T61382Medicare UPIN