Provider Demographics
NPI:1508015660
Name:MCGINLEY EYE ASSOCIATES S.C.
Entity Type:Organization
Organization Name:MCGINLEY EYE ASSOCIATES S.C.
Other - Org Name:OPITX ON DOWNER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:B
Authorized Official - Last Name:MCGINLEY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:414-287-0070
Mailing Address - Street 1:2634 N DOWNER AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53211-4244
Mailing Address - Country:US
Mailing Address - Phone:414-964-3125
Mailing Address - Fax:414-963-3984
Practice Address - Street 1:2634 N DOWNER AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53211-4244
Practice Address - Country:US
Practice Address - Phone:414-964-3125
Practice Address - Fax:414-963-3984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-14
Last Update Date:2009-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2854152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
000047281Medicare PIN