Organization
LAKE COUNTRY EYE SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT MCCARVILLE (ADMINISTRATOR)
(417) 889-2040
Entity
Organization
Contact information
Practice address
N19W23993 RIDGEVIEW PKWY W, WAUKESHA, WI 53188-1030
(417) 889-2040
Mailing address
N19W23993 RIDGEVIEW PKWY W, WAUKESHA, WI 53188-1030
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
10/08/2025
Last updated
10/08/2025
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