Provider Demographics
NPI:1568244192
Name:TOWER CLOCK SURGERY CENTER APPLETON, LLC
Entity Type:Organization
Organization Name:TOWER CLOCK SURGERY CENTER APPLETON, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPHTHALMOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:J
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:920-497-1810
Mailing Address - Street 1:3120 N RICHMOND ST
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54911-1151
Mailing Address - Country:US
Mailing Address - Phone:920-497-1810
Mailing Address - Fax:920-497-1830
Practice Address - Street 1:3120 N RICHMOND ST
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54911-1151
Practice Address - Country:US
Practice Address - Phone:920-497-1810
Practice Address - Fax:920-497-1830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-18
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical