Provider Demographics
NPI:1649323411
Name:HULEN, JAMES J (OD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:J
Last Name:HULEN
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 1:515 N GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53186
Mailing Address - Country:US
Mailing Address - Phone:262-544-4722
Mailing Address - Fax:262-544-4344
Practice Address - Street 1:515 N GRAND AVE
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53186
Practice Address - Country:US
Practice Address - Phone:262-544-4722
Practice Address - Fax:262-544-4344
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1445152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38533300Medicaid
T62269Medicare UPIN
WI38533300Medicaid