Organization
FOX CITIES EYE CLINIC, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK C AUSTIN MD (PHYSICIAN/OWNER)
(920) 734-8714
Entity
Organization
Contact information
Practice address
1301 E NORTHLAND AVE STE A, APPLETON, WI 54911-8582
(920) 734-8714
Mailing address
1301 E NORTHLAND AVE STE A, APPLETON, WI 54911-8582
(920) 734-8714
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32890500
—
WI
01
—
CH2565
RAILROAD MEDICARE
WI
Enumeration date
07/25/2006
Last updated
11/25/2014
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