Provider Demographics
NPI:1801987599
Name:WEBB, PAUL BENJAMIN (OD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:BENJAMIN
Last Name:WEBB
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 1:920 STATE RD 136
Mailing Address - Street 2:VISION CENTER
Mailing Address - City:BARABOO
Mailing Address - State:WI
Mailing Address - Zip Code:53913-4160
Mailing Address - Country:US
Mailing Address - Phone:312-841-7720
Mailing Address - Fax:608-356-6276
Practice Address - Street 1:920 STATE ROAD 136
Practice Address - Street 2:VISION CENTER
Practice Address - City:BARABOO
Practice Address - State:WI
Practice Address - Zip Code:53913-9254
Practice Address - Country:US
Practice Address - Phone:608-356-6276
Practice Address - Fax:866-318-0547
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3058-035152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist