Provider Demographics
NPI:1841032224
Name:DELGADO, JOSEPH ALLEN (OD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:ALLEN
Last Name:DELGADO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:500 FREMONT ST
Mailing Address - Street 2:
Mailing Address - City:KIEL
Mailing Address - State:WI
Mailing Address - Zip Code:53042-1319
Mailing Address - Country:US
Mailing Address - Phone:920-894-2727
Mailing Address - Fax:920-894-7777
Practice Address - Street 1:1405 MILWAUKEE DR
Practice Address - Street 2:
Practice Address - City:NEW HOLSTEIN
Practice Address - State:WI
Practice Address - Zip Code:53061-1430
Practice Address - Country:US
Practice Address - Phone:920-898-5531
Practice Address - Fax:920-898-1581
Is Sole Proprietor?:No
Enumeration Date:2024-06-07
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4018-35152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist