Basic Information
Provider Information
NPI: 1912956764
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PARISEAU
FirstName: BRETT
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1025 REGENT ST
Address2:  
City: MADISON
State: WI
PostalCode: 537151248
CountryCode: US
TelephoneNumber: 6082528000
FaxNumber: 6082822172
Practice Location
Address1: 1025 REGENT ST
Address2:  
City: MADISON
State: WI
PostalCode: 537151248
CountryCode: US
TelephoneNumber: 6082528000
FaxNumber: 6082822172
Other Information
ProviderEnumerationDate: 05/09/2006
LastUpdateDate: 06/04/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/04/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207W00000X48321-020WIY Allopathic & Osteopathic PhysiciansOphthalmology 

No ID Information.


Home