Organization
GONNERING EYE CONSULTANTS, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL S GONNERING M.D. (OWNER)
(414) 778-3224
Entity
Organization
Contact information
Practice address
2900 W OKLAHOMA AVE, MILWAUKEE, WI 53215-4330
(414) 778-3224
Mailing address
11716 W GREENFIELD AVE, WEST ALLIS, WI 53214-2156
(414) 778-3224
(414) 778-3886
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
20265020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30320200
—
WI
Enumeration date
01/12/2007
Last updated
08/22/2020
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