Healthcare Provider Details

I. General information

NPI: 1063326049
Provider Name (Legal Business Name): INSIGHT EYE CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

919 W KENNEDY AVE STE A
KIMBERLY WI
54136-2205
US

IV. Provider business mailing address

251 N SAWYER ST
OSHKOSH WI
54902-4251
US

V. Phone/Fax

Practice location:
  • Phone: 920-733-0919
  • Fax:
Mailing address:
  • Phone: 920-235-5530
  • Fax: 920-235-6406

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number StateNULL

VIII. Authorized Official

Name: SHELLY DIX
Title or Position: ACCOUNT SPECIALIST
Credential:
Phone: 920-235-5530