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LADD F. KORESCH O.D. S.C. NPI 1104029867


NPI Information

NPI: 1104029867
Provider Name: LADD F. KORESCH O.D., S.C.
Classification: Optometrist - 152W00000X
Entity Type: Organization
Address:
415 BROAD ST
SUITE 101
LAKE GENEVA, WI
ZIP 53147
Phone: (262) 248-4878
Get Directions

LADD F. KORESCH O.D., S.C. is an optometrist in Lake Geneva, WI. The provider is doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. LADD F. KORESCH O.D., S.C. NPI is 1104029867. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

415 BROAD ST
SUITE 101
LAKE GENEVA, WI
ZIP 53147-800
Phone: (262) 248-4878
Fax: (262) 248-1100

The provider's authorized official is Ladd F. Koresch .
The authorized official title is Optometrist and has the following contact phone number (262) 248-4878.

The enumeration date for this NPI number is 6/8/2007 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1152W00000XOptometrist1228-035WISCONSINYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
138556600MEDICAIDWISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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