Organization
EYE PHYSICIAN ASSOCIATES, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES B YANG MD (PRESIDENT)
(414) 928-2020
Entity
Organization
Contact information
Practice address
4300 W. LAYTON AVE, STE 100, MILWAUKEE, WI 53220-5132
(414) 928-2020
(414) 210-3402
Mailing address
4300 W. LAYTON AVE, STE 100, MILWAUKEE, WI 53220-5132
(414) 928-2020
(414) 210-3402
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000073822
MILWAUKEE PTAN
WI
01
—
0264580001
DMEPOS ASSIGNED
—
05
—
100189991
—
WI
05
—
32306500
—
WI
05
—
32735700
—
WI
05
—
34249800
—
WI
05
—
34678800
—
WI
05
—
38622400
—
WI
05
—
38632200
—
WI
01
—
73605
WISCONSIN PHYSICIAN SERVI
WI
01
—
=========
BLUE CROSS
WI
01
—
=========
HUMANA
—
01
—
C01777
RAILROAD MEDICARE
—
Enumeration date
01/20/2006
Last updated
11/06/2024
Update your record
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