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Organization
SUSON EYE SPECIALISTS, MD SC
Active
Organization
SUSON EYE SPECIALISTS, MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN DAVID SUSON M.D. (MANAGING DOCTOR)
(414) 475-5550
Entity
Organization
Contact information
Practice address
2300 N MAYFAIR RD, SUITE 1101, WAUWATOSA, WI 53226-1505
(414) 475-5550
(414) 475-0249
Mailing address
2300 N MAYFAIR RD, SUITE 1101, WAUWATOSA, WI 53226-1505
(414) 475-5550
(414) 475-0249
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
33392
WI
207W00000X
Ophthalmology Physician
Primary
34950
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30936300
—
WI
05
—
32169600
—
WI
05
—
32237800
—
WI
05
—
38530200
—
WI
Enumeration date
03/14/2006
Last updated
11/12/2012
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