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General NPI Number Information
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NPI Number | 1619871175
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Entity Type | Organization
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Legal Business Name | MEQUON FAMILY EYE CARE, LLC
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Dates
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Enumeration Date | 10/06/2026
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Last Update Date | 10/09/2026
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Provider Practice Location Address
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Address Line | 6001 W MEQUON RD
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City | MEQUON
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State | WI
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Zip | 53092-1950
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Country | US
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Telephone | 262-352-2560
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Fax |
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Provider Business Mailing Address
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Address Line | 6001 W MEQUON RD
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City | MEQUON
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State | WI
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Zip | 53092-1950
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. WILLIAM COLIN SMITH
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Credential | OD
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Telephone | 262-352-2560
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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 | NULL
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