Organization
THIRD COAST RETINA S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLINTON WARREN MD (PRESIDENT)
(262) 420-5888
Entity
Organization
Contact information
Practice address
5017 GREEN BAY RD STE 148, KENOSHA, WI 53144-1782
(262) 420-5888
Mailing address
5017 GREEN BAY RD STE 148, KENOSHA, WI 53144-1782
(336) 692-3384
Taxonomy
Speciality
Code
Description
License number
State
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
—
—
Other
Enumeration date
07/13/2022
Last updated
08/10/2022
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