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General NPI Number Information
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NPI Number | 1366203259
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Entity Type | Organization
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Legal Business Name | WISCONSIN EYE CONSULTANTS S. C.
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Dates
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Enumeration Date | 01/18/2024
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Last Update Date | 09/24/2025
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Provider Practice Location Address
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Address Line | 878 W AIRPORT RD
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City | MENASHA
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State | WI
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Zip | 54952-1461
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Country | US
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Telephone | 920-806-3005
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Fax |
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Provider Business Mailing Address
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Address Line | 878 W AIRPORT RD
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City | MENASHA
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State | WI
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Zip | 54952-1461
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Country | US
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Telephone | 920-806-3005
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Fax | 920-806-3004
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOSEPH NEILITZ
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Credential | DO
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Telephone | 920-806-3005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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