Provider Demographics
NPI:1447355227
Name:DEGENER, JAMES KENT (OD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:KENT
Last Name:DEGENER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:20908 COUNTY HIGHWAY T
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:WI
Mailing Address - Zip Code:54648-8016
Mailing Address - Country:US
Mailing Address - Phone:608-343-0926
Mailing Address - Fax:
Practice Address - Street 1:920 HIGHWAY 12
Practice Address - Street 2:
Practice Address - City:BARABOO
Practice Address - State:WI
Practice Address - Zip Code:53913
Practice Address - Country:US
Practice Address - Phone:608-356-6276
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1462152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist