# EYE CLINIC OF WISCONSIN, S.C.

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

## Provider details

- **NPI number:** 1235113655
- **Authorized official:** DOUGLAS T. EDWARDS MD (MD/OWNER)
- **Authorized official phone:** (715) 261-8500

## Contact information

- **Practice address:** 1207 O'DAY ST, MERRILL, WI 54452
- **Practice address phone:** (715) 536-2535
- **Practice address fax:** (715) 536-1261
- **Mailing address:** 800 N 1ST ST, WAUSAU, WI 54403-4754
- **Mailing address phone:** (715) 261-8500

## Taxonomy

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

## Other

- **Enumeration date:** 11/30/2005
- **Last updated:** 01/21/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 32667800 | — | WI |