NORTHEAST WISCONSIN VISION CENTER LTD. NPI 1295715415

NPI Information

  • NPI: 1295715415
  • Provider Name: NORTHEAST WISCONSIN VISION CENTER, LTD.
  • Classification: Ophthalmology - 207W00000X
  • Entity Type: Organization
  • CLIA Number: 52D2125604
  • Address: 2130 S WASHBURN ST
    OSHKOSH, WI
    ZIP 54904
  • Phone: (920) 232-6550

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NPI Details

NORTHEAST WISCONSIN VISION CENTER, LTD. is an ophthalmology in Oshkosh, WI. The provider is an ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. NORTHEAST WISCONSIN VISION CENTER, LTD. NPI is 1295715415. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2130 S WASHBURN ST
OSHKOSH, WI
ZIP 54904-949
Phone: (920) 232-6550
Fax: (920) 232-6552

The provider's authorized official is Eric M Larson .
The authorized official title is President and has the following contact phone number (920) 232-6550.

The CLIA number assigned to this NPI record is 52D2125604 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/23/2006 and was last updated on 1/16/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1152W00000XOptometristNo
2207W00000XOphthalmologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
132863800MEDICAIDWISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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