Dr Randy Joseph Wild, OD - Optometrist in Neenah, WI

Dr Randy Joseph Wild, OD is a Optometrist based in Neenah, Wisconsin. Dr Randy Joseph Wild is licensed to practice in Wisconsin (license number 1706) and his current practice location is 1111 Maple St, Neenah, Wisconsin. He can be reached at his office (for appointments etc.) via phone at (920) 722-7411.

NPI number for Dr Randy Joseph Wild is 1891812749 and his current mailing address is 1111 Maple St, Neenah, Wisconsin. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1891812749.

Contact Information

Dr Randy Joseph Wild, OD
1111 Maple St,
Neenah, WI 54956-4122
(920) 722-7411
Not Available



Healthcare Provider's Profile

Full NameDr Randy Joseph Wild
GenderMale
SpecialityOptometrist
Location1111 Maple St, Neenah, Wisconsin
Accepts Medicare AssignmentsDoes not participate in Medicare Program. He may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1891812749
  • Provider Enumeration Date: 03/24/2007
  • Last Update Date: 06/06/2008

Medical Identifiers

Medical identifiers for Dr Randy Joseph Wild such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1891812749NPI-NPPES
38509100MedicaidWI

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
152W00000XOptometrist 1706 (Wisconsin)Primary
152WC0802XOptometrist - Corneal And Contact Management 1706 (Wisconsin)Secondary
152WP0200XOptometrist - Pediatrics 1706 (Wisconsin)Secondary
152WS0006XOptometrist - Sports Vision 1706 (Wisconsin)Secondary
152WV0400XOptometrist - Vision Therapy 1706 (Wisconsin)Secondary
152WX0102XOptometrist - Occupational Vision 1706 (Wisconsin)Secondary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Randy Joseph Wild is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Randy Joseph Wild, OD
1111 Maple St,
Neenah, WI 54956-4122

Ph: () -
Dr Randy Joseph Wild, OD
1111 Maple St,
Neenah, WI 54956-4122

Ph: (920) 722-7411

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