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Organization
WISCONSIN OPTOMETRIC EYE DOCTOR, INC.
Active
Organization
WISCONSIN OPTOMETRIC EYE DOCTOR, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC RICHARD TYLER (OWNER/OPTOMETRIST)
(651) 206-2418
Entity
Organization
Contact information
Practice address
N2577 PLAZA RD # WI-73, WAUTOMA, WI 54982-7706
(920) 787-3837
Mailing address
N2577 PLAZA RD # WI-73, WAUTOMA, WI 54982-7706
(920) 787-3837
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
NULL
152W00000X
Optometrist
—
—
152WC0802X
Corneal and Contact Management Optometrist
Primary
—
NULL
152WC0802X
Corneal and Contact Management Optometrist
Primary
—
—
Other
Enumeration date
07/30/2020
Last updated
09/09/2025
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