Provider Demographics
NPI:1770786196
Name:G. B. GINSBERG, O.D.
Entity type:Organization
Organization Name:G. B. GINSBERG, O.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:BENJAMIN
Authorized Official - Last Name:GINSBERG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:715-425-7228
Mailing Address - Street 1:117 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RIVER FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54022-2449
Mailing Address - Country:US
Mailing Address - Phone:715-425-7228
Mailing Address - Fax:715-425-7757
Practice Address - Street 1:117 S MAIN ST
Practice Address - Street 2:
Practice Address - City:RIVER FALLS
Practice Address - State:WI
Practice Address - Zip Code:54022-2449
Practice Address - Country:US
Practice Address - Phone:715-425-7228
Practice Address - Fax:715-425-7757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-06
Last Update Date:2015-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1469152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty