# EYE PHYSICIAN ASSOCIATES, S.C.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Loomis Optical
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174217178
- **Authorized official:** DR. CHARLES B YANG MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (414) 928-2020

## Contact information

- **Practice address:** 4300 WEST LAYTON AVENUE, STE 100, GREENFIELD, WI 53220-5132
- **Practice address phone:** (414) 928-2020
- **Practice address fax:** (414) 210-3402
- **Mailing address:** 4300 W. LAYTON AVE, STE 100, GREENFIELD, WI 53220-4136
- **Mailing address phone:** (414) 260-0789

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | — | NULL | — |
| 152W00000X | Optometrist | — | — | — |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/05/2023
- **Last updated:** 03/19/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0264580001 | DME | WI |
| 05 | — | 32306500 | — | WI |
| 05 | — | 32735700 | — | WI |
| 05 | — | 34249800 | — | WI |
| 05 | — | 34678800 | — | WI |
| 05 | — | 38616200 | — | WI |
| 05 | — | 38622400 | — | WI |