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SULLIVAN EYE CENTER S.C. NPI 1104919869


NPI Information

NPI: 1104919869
Provider Name: SULLIVAN EYE CENTER, S.C.
Classification: Ophthalmology - 207W00000X
Entity Type: Organization
Address:
1195 N CASALOMA DR
APPLETON, WI
ZIP 54913
Phone: (920) 734-0400
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SULLIVAN EYE CENTER, S.C. is an ophthalmology in Appleton, WI. The provider is an ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. SULLIVAN EYE CENTER, S.C. NPI is 1104919869. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

1195 N CASALOMA DR
APPLETON, WI
ZIP 54913-295
Phone: (920) 734-0400
Fax: (920) 734-9054

The provider's authorized official is Robert D. Sullivan .
The authorized official title is President and has the following contact phone number (920) 734-0400.

The enumeration date for this NPI number is 10/2/2006 and was last updated on 9/3/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1152W00000XOptometrist2483-035WISCONSINNo
2152W00000XOptometrist2752-035WISCONSINNo
3152W00000XOptometrist2681-035WISCONSINNo
4207W00000XOphthalmology18799WISCONSINYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1CT0649MEDICARE PIN
238455900MEDICAIDWISCONSIN
3000045385MEDICARE PIN
40533940001MEDICARE NSC

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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