Provider Demographics
NPI:1518949056
Name:VISION CLINIC DR. SAVIN & ASSOCIATES
Entity Type:Organization
Organization Name:VISION CLINIC DR. SAVIN & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:A
Authorized Official - Last Name:SAVIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:262-637-7494
Mailing Address - Street 1:1421 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53403-2254
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1421 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:RACINE
Practice Address - State:WI
Practice Address - Zip Code:53403-2254
Practice Address - Country:US
Practice Address - Phone:262-637-7494
Practice Address - Fax:262-637-7958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI152W00000X, 152WC0802X, 152WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
No152WP0200XEye and Vision Services ProvidersOptometristPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38711300Medicaid
WI31668OtherDAVIS VISION
WI511065OtherNATIONAL VISION ADMINISTR
WIVI10311OtherSPECTERA
WIVI658095OtherCLARITY VISION
WI068028OtherVISION INSURANCE PLAN OF
WI111632OtherEYEMED
WI111632OtherEYEMED
WI0643310001Medicare NSC