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General NPI Number Information
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NPI Number | 1578554390
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Entity Type | Organization
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Legal Business Name | ISTHMUS EYE CARE SC
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Dates
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Enumeration Date | 11/01/2005
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Last Update Date | 06/13/2008
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Provider Practice Location Address
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Address Line | 7601 UNIVERSITY AVE STE 102
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City | MIDDLETON
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State | WI
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Zip | 53562-5414
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Country | US
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Telephone | 608-831-3366
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Fax | 608-831-8470
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Provider Business Mailing Address
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Address Line | 7601 UNIVERSITY AVE STE 102
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City | MIDDLETON
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State | WI
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Zip | 53562-5414
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Country | US
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Telephone | 608-831-3366
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Fax | 608-831-8470
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Authorized Official
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Title or Position | PRESIDENT
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Name | VICTOR J CONNORS
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Credential | OD
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Telephone | 608-831-3366
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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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