Sullivan Eye Center, S.C.

LBN: Sullivan Eye Center, S.C.
Sullivan Eye Center, S.C. is an health care organization with primary practice located at 1195 N Casaloma Dr , Appleton WI 54913-9295. The organization recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Allopathic & Osteopathic Physicians / Ophthalmology. Allopathic & Osteopathic Physicians / Ophthalmology is the primary health care specialty. Sullivan Eye Center, S.C. can be contacted via phone (920) 734-0400, or through Sullivan, Robert D. via phone (920) 734-0400.

Contact Information

Primary practice address
1195 N Casaloma Dr Appleton WI 54913-9295
Phone: (920) 734-0400
Fax: (920) 734-9054
Website:
Map and Directions
Authorized official contact:
Name: Sullivan, Robert D. Doctor of Medicine (MD)
Phone: (920) 734-0400

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 2483-035 Wisconsin
Eye and Vision Services Providers / Optometrist 152W00000X 2752-035 Wisconsin
Eye and Vision Services Providers / Optometrist 152W00000X 2681-035 Wisconsin
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 18799 Wisconsin

Profile Details

NPI number 1104919869
LBN Legal business name Sullivan Eye Center, S.C.
DBA Doing business as
Authorized official Sullivan, Robert D. Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 2nd, 2006
Last updated Sep 3rd, 2008 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104919869 NPPES
Wisconsin MEDICAID 38455900

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