Provider Demographics
NPI:1831398437
Name:INSIGHT EYE CARE, LLC
Entity type:Organization
Organization Name:INSIGHT EYE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:PARKE
Authorized Official - Last Name:AMES
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:920-235-5530
Mailing Address - Street 1:251 N SAWYER ST
Mailing Address - Street 2:
Mailing Address - City:OSHKOSH
Mailing Address - State:WI
Mailing Address - Zip Code:54902-4251
Mailing Address - Country:US
Mailing Address - Phone:920-235-5530
Mailing Address - Fax:920-235-6406
Practice Address - Street 1:251 N SAWYER ST
Practice Address - Street 2:
Practice Address - City:OSHKOSH
Practice Address - State:WI
Practice Address - Zip Code:54902-4251
Practice Address - Country:US
Practice Address - Phone:920-235-5530
Practice Address - Fax:920-235-6406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-13
Last Update Date:2018-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI6192120002Medicare NSC