# SUSON EYE SPECIALISTS, MD SC

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

## Provider details

- **NPI number:** 1699744573
- **Authorized official:** DR. JOHN DAVID SUSON M.D. (MANAGING DOCTOR)
- **Authorized official phone:** (414) 475-5550

## Contact information

- **Practice address:** 2300 N MAYFAIR RD, SUITE 1101, WAUWATOSA, WI 53226-1505
- **Practice address phone:** (414) 475-5550
- **Practice address fax:** (414) 475-0249
- **Mailing address:** 2300 N MAYFAIR RD, SUITE 1101, WAUWATOSA, WI 53226-1505
- **Mailing address phone:** (414) 475-5550
- **Mailing address fax:** (414) 475-0249

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | 33392 | WI | — |
| 207W00000X | Ophthalmology Physician | 34950 | WI | Yes |

## Other

- **Enumeration date:** 03/14/2006
- **Last updated:** 11/12/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 30936300 | — | WI |
| 05 | — | 32169600 | — | WI |
| 05 | — | 32237800 | — | WI |
| 05 | — | 38530200 | — | WI |