Provider Demographics
NPI:1932282928
Name:KIND OPTICAL INC
Entity Type:Organization
Organization Name:KIND OPTICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:FOSTER
Authorized Official - Last Name:MERKLE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:414-543-2900
Mailing Address - Street 1:3925 S 76TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53220-2320
Mailing Address - Country:US
Mailing Address - Phone:414-543-2900
Mailing Address - Fax:414-543-9130
Practice Address - Street 1:3925 S 76TH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53220-2320
Practice Address - Country:US
Practice Address - Phone:414-543-2900
Practice Address - Fax:414-543-9130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2009-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1595-035152W00000X
156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI10458OtherNVA
WI38514800Medicaid
WI340000OtherVIPA
WI113872OtherEYEMED
WI113872OtherEYEMED
WIU33393Medicare UPIN