# NORTHERN WATERS OPHTHALMOLOGY SC

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

## Provider details

- **NPI number:** 1952354698
- **Authorized official:** MARK W SNEED MD (PRESIDENT)
- **Authorized official phone:** (715) 682-0363

## Contact information

- **Practice address:** 2111 BEASER AVE, ASHLAND, WI 54806-3608
- **Practice address phone:** (715) 682-0363
- **Practice address fax:** (715) 682-9638
- **Mailing address:** 2111 BEASER AVE, ASHLAND, WI 54806-3608
- **Mailing address phone:** (715) 682-0363
- **Mailing address fax:** (715) 682-9638

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/17/2006
- **Last updated:** 09/11/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 32838900 | — | WI |