Provider Demographics
NPI:1487704128
Name:VISION & EYE HEALTH ASSOCIATES
Entity type:Organization
Organization Name:VISION & EYE HEALTH ASSOCIATES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TERI
Authorized Official - Middle Name:R
Authorized Official - Last Name:KUHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-248-9200
Mailing Address - Street 1:253 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:LAKE GENEVA
Mailing Address - State:WI
Mailing Address - Zip Code:53147-1982
Mailing Address - Country:US
Mailing Address - Phone:262-248-9200
Mailing Address - Fax:
Practice Address - Street 1:253 CENTER ST
Practice Address - Street 2:
Practice Address - City:LAKE GENEVA
Practice Address - State:WI
Practice Address - Zip Code:53147-1982
Practice Address - Country:US
Practice Address - Phone:262-248-9200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI000047270Medicare PIN
WI0289160001Medicare NSC