Organization
EYE PHYSICIAN ASSOCIATES, S.C.
Active
Parent organization
EYE PHYSICIAN ASSOCIATES (OPTICAL)
Other names
Eye Physician Associates, S.C.
Organization subpart
Yes
Provider details
NPI number
Legal business name
EYE PHYSICIAN ASSOCIATES (OPTICAL)
Authorized official
DR. CHARLES YANG M.D. (PRESIDENT)
(414) 928-2020
Entity
Organization
Contact information
Practice address
1249 W LIEBAU RD, SUITE 102, MEQUON, WI 53092-3396
(262) 243-3001
(262) 243-3006
Mailing address
4300 W. LAYTON AVE, STE 100, GREENFIELD, WI 53220-4136
(414) 260-0789
(414) 210-3402
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
3427120
WI
207W00000X
Ophthalmology Physician
Primary
3867120
WI
207W00000X
Ophthalmology Physician
4492620
WI
207W00000X
Ophthalmology Physician
4839520
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000046037
OZAUKEE PTAN
WI
05
—
100189991
—
WI
01
—
124580001
DMEPOS ASSIGNED
WI
05
—
1851590343
—
WI
05
—
32306500
—
WI
05
—
32735700
—
WI
05
—
34249800
—
WI
05
—
34678800
—
WI
05
—
38616200
—
WI
05
—
38622400
—
WI
05
—
38632200
—
WI
01
—
73605
WPS
—
01
—
C017777
RR MEDICARE
WI
Enumeration date
04/06/2011
Last updated
03/20/2024
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