Provider Demographics
NPI:1255585915
Name:CHERNEY, DUSTIN ANDREW (OD)
Entity type:Individual
Prefix:MR
First Name:DUSTIN
Middle Name:ANDREW
Last Name:CHERNEY
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 1:3424 MORMON COULEE RD
Mailing Address - Street 2:STE A
Mailing Address - City:LA CROSSE
Mailing Address - State:WI
Mailing Address - Zip Code:54601-6703
Mailing Address - Country:US
Mailing Address - Phone:608-788-4300
Mailing Address - Fax:608-788-4325
Practice Address - Street 1:3424 MORMON COULEE RD
Practice Address - Street 2:
Practice Address - City:LA CROSSE
Practice Address - State:WI
Practice Address - Zip Code:54601-6702
Practice Address - Country:US
Practice Address - Phone:608-788-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-07
Last Update Date:2016-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3403-35152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist