Individual
TYSON KARL SCHWIESOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1087 W MASON STREET, GREEN BAY, WI 54303-1859
(920) 499-3102
(920) 499-9636
Mailing address
1087 W MASON STREET, GREEN BAY, WI 54303-1859
(920) 499-3102
(920) 499-9636
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
41186020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34222000
—
WI
Enumeration date
09/01/2006
Last updated
12/20/2021
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