Provider Demographics
NPI:1518919596
Name:LACOUNT, CARIN M (OD)
Entity Type:Individual
Prefix:DR
First Name:CARIN
Middle Name:M
Last Name:LACOUNT
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:CARIN
Other - Middle Name:M
Other - Last Name:LACOUNT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:616 W JOHNSON ST
Mailing Address - Street 2:
Mailing Address - City:FOND DU LAC
Mailing Address - State:WI
Mailing Address - Zip Code:54935-3134
Mailing Address - Country:US
Mailing Address - Phone:920-921-8290
Mailing Address - Fax:920-921-7112
Practice Address - Street 1:616 W JOHNSON ST
Practice Address - Street 2:
Practice Address - City:FOND DU LAC
Practice Address - State:WI
Practice Address - Zip Code:54935-3134
Practice Address - Country:US
Practice Address - Phone:920-921-8290
Practice Address - Fax:920-921-7112
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2614152W00000X
WI2614-35152W00000X
TX10158T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist