# EYE CARE SURGICAL CONSULTING SC

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

## Provider details

- **NPI number:** 1740443704
- **Authorized official:** JODY R LAPORTE (MANAGER)
- **Authorized official phone:** (262) 752-2020

## Contact information

- **Practice address:** 4060 N MAIN ST, RACINE, WI 53402-3121
- **Practice address phone:** (262) 752-2020
- **Mailing address:** 4060 N MAIN ST, RACINE, WI 53402-3121
- **Mailing address phone:** (262) 752-2020

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | 26907-020 | WI | Yes |

## Other

- **Enumeration date:** 07/09/2008
- **Last updated:** 02/15/2009