Provider Demographics
NPI:1912955618
Name:FILAR, PAUL ANDREW (OD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:ANDREW
Last Name:FILAR
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 1:1532 MICHIGAN ST
Mailing Address - Street 2:
Mailing Address - City:STURGEON BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54235-2742
Mailing Address - Country:US
Mailing Address - Phone:920-743-5053
Mailing Address - Fax:920-743-8802
Practice Address - Street 1:1532 MICHIGAN ST
Practice Address - Street 2:
Practice Address - City:STURGEON BAY
Practice Address - State:WI
Practice Address - Zip Code:54235-2742
Practice Address - Country:US
Practice Address - Phone:920-743-5053
Practice Address - Fax:920-743-8802
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3003152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38624800Medicaid
WIVO2336Medicare UPIN
WI38624800Medicaid
WI000147890 AR42Medicare ID - Type Unspecified