Provider Demographics
NPI:1366203259
Name:WISCONSIN EYE CONSULTANTS S. C.
Entity type:Organization
Organization Name:WISCONSIN EYE CONSULTANTS S. C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:NEILITZ
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:920-806-3005
Mailing Address - Street 1:878 W AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:MENASHA
Mailing Address - State:WI
Mailing Address - Zip Code:54952-1461
Mailing Address - Country:US
Mailing Address - Phone:920-806-3005
Mailing Address - Fax:920-806-3004
Practice Address - Street 1:878 W AIRPORT RD
Practice Address - Street 2:
Practice Address - City:MENASHA
Practice Address - State:WI
Practice Address - Zip Code:54952-1461
Practice Address - Country:US
Practice Address - Phone:920-806-3005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-18
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty