Organization
WISCONSIN RETINA, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAY A MET M.D. (PRESIDENT)
(414) 777-0110
Entity
Organization
Contact information
Practice address
2600 N MAYFAIR RD STE 350, MILWAUKEE, WI 53226-1372
(414) 777-0110
(414) 777-0330
Mailing address
2600 N MAYFAIR RD STE 350, MILWAUKEE, WI 53226-1372
(414) 777-0110
(414) 777-0330
Taxonomy
Speciality
Code
Description
License number
State
261QS0132X
Ophthalmologic Surgery Clinic/Center
Primary
39513
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32394500
—
WI
Enumeration date
04/03/2007
Last updated
08/22/2020
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