Provider Demographics
NPI:1588633044
Name:DAVIS, NELSON AND ASSOCIATES, INC
Entity Type:Organization
Organization Name:DAVIS, NELSON AND ASSOCIATES, INC
Other - Org Name:EYE CONTACT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:WADE
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:608-833-4242
Mailing Address - Street 1:7428 MINERAL POINT RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53717-1710
Mailing Address - Country:US
Mailing Address - Phone:608-833-4242
Mailing Address - Fax:608-833-4248
Practice Address - Street 1:7428 MINERAL POINT RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53717-1710
Practice Address - Country:US
Practice Address - Phone:608-833-4242
Practice Address - Fax:608-833-4248
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2097152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIU26518Medicare UPIN