Individual
DR. SUSAN ANN GORZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1217 ELLIS ST, KEWAUNEE, WI 54216-1825
(920) 388-2020
(920) 388-3594
Mailing address
1021 JEFFERSON ST, ALGOMA, WI 54201-1737
(920) 487-2077
(920) 487-9770
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2044
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000147383
MEDICARE PTAN
WI
01
—
037174001
MEDICARE NSC
WI
05
—
38526300
—
WI
05
—
38709200
—
WI
01
—
87544
MEDICARE
WI
01
—
87727
MEDICARE
WI
Enumeration date
12/07/2005
Last updated
01/09/2019
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