BARNETT WAMBOLDT EYECARE SC NPI 1497905129

NPI Information

  • NPI: 1497905129
  • Provider Name: BARNETT WAMBOLDT EYECARE, SC
  • Classification: Clinic/Center - 261QP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • Address: 6116-39 AVE
    KENOSHA, WI
    ZIP 53142
  • Phone: (262) 653-0100

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NPI Details

BARNETT WAMBOLDT EYECARE, SC is a primary care clinic center in Kenosha, WI. BARNETT WAMBOLDT EYECARE, SC NPI is 1497905129. The provider is registered as an organization entity type.

The provider's business location address is:

6116-39 AVE
KENOSHA, WI
ZIP 53142
Phone: (262) 653-0100
Fax: (262) 653-0200

The provider's authorized official is Debra Jeanne Barnett-wamboldt .
The authorized official title is President and has the following contact phone number (262) 697-3665.

The enumeration date for this NPI number is 9/30/2008 and was last updated on 1/28/2009.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QP2300XClinic/CenterPrimary Care2407-035WISCONSINYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
138585300MEDICAIDWISCONSIN
2WI1065MEDICARE PINWISCONSIN
3U25331MEDICARE UPINWISCONSIN

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: 3/30/2025

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