Search › Wisconsin › 1223G0001X
Omid Khaksarfard
NPI 1780403477 · on the registry since 2024 · sole proprietor
Practice
- Address
- 6035 Durand Ave
Mt Pleasant, WI 53406 - Phone
- (262) 270-6933
Registry record
- Primary taxonomy
- 1223G0001X
1223G0001X
- Licence states on file
- WI
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2025-10-05
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Wisconsin