# EYE PHYSICIAN ASSOCIATES, S.C.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** EYE PHYSICIAN ASSOCIATES (OPTICAL)
- **Other names:** Eye Physician Associates, S.C.
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1427347822
- **Legal business name:** EYE PHYSICIAN ASSOCIATES (OPTICAL)
- **Authorized official:** DR. CHARLES YANG M.D. (PRESIDENT)
- **Authorized official phone:** (414) 928-2020

## Contact information

- **Practice address:** 1249 W LIEBAU RD, SUITE 102, MEQUON, WI 53092-3396
- **Practice address phone:** (262) 243-3001
- **Practice address fax:** (262) 243-3006
- **Mailing address:** 4300 W. LAYTON AVE, STE 100, GREENFIELD, WI 53220-4136
- **Mailing address phone:** (414) 260-0789
- **Mailing address fax:** (414) 210-3402

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | 3427120 | WI | — |
| 207W00000X | Ophthalmology Physician | 3867120 | WI | Yes |
| 207W00000X | Ophthalmology Physician | 4492620 | WI | — |
| 207W00000X | Ophthalmology Physician | 4839520 | WI | — |

## Other

- **Enumeration date:** 04/06/2011
- **Last updated:** 03/20/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000046037 | OZAUKEE PTAN | WI |
| 05 | — | 100189991 | — | WI |
| 01 | — | 124580001 | DMEPOS ASSIGNED | WI |
| 05 | — | 1851590343 | — | WI |
| 05 | — | 32306500 | — | WI |
| 05 | — | 32735700 | — | WI |
| 05 | — | 34249800 | — | WI |
| 05 | — | 34678800 | — | WI |
| 05 | — | 38616200 | — | WI |
| 05 | — | 38622400 | — | WI |
| 05 | — | 38632200 | — | WI |
| 01 | — | 73605 | WPS | — |
| 01 | — | C017777 | RR MEDICARE | WI |