# EYE CLINIC OF WISCONSIN, SC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114315587
- **Authorized official:** TERRI YEAGER (ADMINISTRATIVE SERVICES MANAGER)
- **Authorized official phone:** (715) 261-8500

## Contact information

- **Practice address:** 841 GOODNOW AVE, SUITE 103, WISCONSIN RAPIDS, WI 54494-0315
- **Practice address phone:** (715) 261-8500
- **Mailing address:** 800 N 1ST ST, WAUSAU, WI 54403-4754
- **Mailing address phone:** (715) 261-8500
- **Mailing address fax:** (715) 261-8667

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/07/2015
- **Last updated:** 01/21/2025