Organization
EYE SURGERY ASSOCIATES, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY KWASNY M.D. (PRESIDENT)
(414) 259-1022
Entity
Organization
Contact information
Practice address
2300 N MAYFAIR RD, MILWAUKEE, WI 53226-1505
(414) 639-0188
Mailing address
PO BOX 5166, ELM GROVE, WI 53122-5166
(414) 639-0188
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
17590
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30939400
—
WI
Enumeration date
08/27/2006
Last updated
05/15/2012
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