Doctor Name: | DR. TAI M CHAN |
NPI Number: | 1508908872 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | O.D. |
License Number: | 1529 |
Business Practice Address: | 1 W Lincoln St Waupun, WI - 539631949 |
Business Phone Number: | 9203245577 |
Business Fax Number: | |
Mailing Address: | 408 Madison St, BEAVER DAM |
State: | WI |
Postal Code: | 539162531 |
Phone Number: | 6083473937 |
Fax Number: | |
NPI Enumeration Date: | 02/13/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 152WC0802X |
License Number: | 1529 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Optometrist |
Taxonomy Specialization: | Corneal and Contact Management |
Taxonomy Definition: | The professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea |