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NORTHEAST WISCONSIN RETINA ASSOCIATES SC NPI 1437164175


NPI Information

NPI: 1437164175
Provider Name: NORTHEAST WISCONSIN RETINA ASSOCIATES SC
Classification: Ophthalmology - 207WX0107X
Entity Type: Organization

Specialization: Retina Specialist

Address:
442 N WESTHILL BLVD STE A
APPLETON, WI
ZIP 54914
Phone: (920) 751-8666
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NORTHEAST WISCONSIN RETINA ASSOCIATES SC is a retina specialist ophthalmology in Appleton, WI. The provider is an ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases. NORTHEAST WISCONSIN RETINA ASSOCIATES SC NPI is 1437164175. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

442 N WESTHILL BLVD STE A
APPLETON, WI
ZIP 54914-830
Phone: (920) 751-8666
Fax: (920) 751-0288

The provider's authorized official is Amy Debruin .
The authorized official title is Billing Department Manager and has the following contact phone number (920) 751-8666.

The enumeration date for this NPI number is 7/30/2006 and was last updated on 8/29/2023.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207WX0107XOphthalmologyRetina SpecialistYes

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: 5/5/2024

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