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Organization

OPHTHALMIC SURGERY OF WI LTD

Active
Other names
Ophthalmic Surgery of Wisconsin Ltd
Organization subpart
No

Provider details

NPI number
Authorized official
GERALD P CLARKE M.D. (PRESIDENT)
(920) 236-4160
Entity
Organization

Contact information

Practice address
509 S WASHBURN ST, OSHKOSH, WI 54904-7949
(920) 236-4160
(920) 236-4166
Mailing address
PO BOX 308, NEENAH, WI 54957-0308
(920) 236-4162
(920) 236-4166

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
32704500
WI
01
CS8378
RETIRED RAILROAD MEDICARE
WI
Enumeration date
11/27/2006
Last updated
06/24/2019
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