Provider Demographics
NPI:1487699195
Name:VERRE EYE CLINIC, S.C.
Entity type:Organization
Organization Name:VERRE EYE CLINIC, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:VERRE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:262-253-4000
Mailing Address - Street 1:N89W16785 APPLETON AVE
Mailing Address - Street 2:
Mailing Address - City:MENOMONEE FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53051-2071
Mailing Address - Country:US
Mailing Address - Phone:262-253-4000
Mailing Address - Fax:262-253-4100
Practice Address - Street 1:N89W16785 APPLETON AVE
Practice Address - Street 2:
Practice Address - City:MENOMONEE FALLS
Practice Address - State:WI
Practice Address - Zip Code:53051-2071
Practice Address - Country:US
Practice Address - Phone:262-253-4000
Practice Address - Fax:262-253-4100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2057-035152W00000X
WI30522-020207W00000X
WI24634-020207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIDA9707Medicare UPIN
WIB57332Medicare UPIN
WI180045978Medicare ID - Type UnspecifiedWILLIAM P VERRE IND RR
WI0210Medicare ID - Type UnspecifiedDR. MARK A. MLSNA, O.D.
WI000467020Medicare ID - Type UnspecifiedMARK MLSNA SEQ NUMBER
WI306 728 00Medicare ID - Type UnspecifiedDR. WILLIAM P. VERRE
WI5177280001Medicare NSC
WVV18837Medicare UPIN
WI000067020Medicare UPIN
WI000167020Medicare ID - Type UnspecifiedDR. WILLIAM P. VERRE, M.D
WVF22255Medicare UPIN