Organization
EYE CLINIC OF WISCONSIN, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS T. EDWARDS MD (MD/OWNER)
(715) 261-8540
Entity
Organization
Contact information
Practice address
309 E BROADWAY AVE, MEDFORD, WI 54451-1835
(715) 748-5775
(715) 748-0667
Mailing address
614 1ST ST, WAUSAU, WI 54403-4851
(715) 845-8201
(715) 848-1722
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32667800
—
WI
Enumeration date
11/28/2005
Last updated
02/17/2025
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