| John P Rosculet, MD | |
|
200 Theda Clark Plaza, Suite 110, Neenah, WI 54956 | |
| (920) 751-8666 | |
| (920) 751-8676 |
| Full Name | John P Rosculet |
|---|---|
| Gender | Male |
| Speciality | Ophthalmology - Retina Specialist |
| Location | 200 Theda Clark Plaza, Neenah, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679580070 | NPI | - | NPPES |
| 31922100 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207WX0107X | Ophthalmology - Retina Specialist | 34273020 (Wisconsin) | Primary |
| Entity Name | Northeast Wisconsin Retina Associates Sc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1437164175 PECOS PAC ID: 8224029707 Enrollment ID: O20040522000093 |
| Mailing Address | Practice Location Address |
|---|---|
| John P Rosculet, MD 200 Theda Clark Plaza, Suite 110, Neenah, WI 54956 Ph: (920) 751-8666 | John P Rosculet, MD 200 Theda Clark Plaza, Suite 110, Neenah, WI 54956 Ph: (920) 751-8666 |
Martin Viebahn, MD Ophthalmology Medicare: Not Enrolled in Medicare Practice Location: 200 Theda Clark Plaza, Suite 110, Neenah, WI 54956 Phone: 920-751-8666 Fax: 920-751-8676 | |
Khalid S Kahook, M.D., Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 200 Theda Clark Plaza, Suite 110, Neenah, WI 54956 Phone: 920-751-8666 Fax: 920-751-0288 | |
Rajeev Buddi, MD Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 200 Theda Clark Pl, Suite 110, Neenah, WI 54956 Phone: 920-751-8666 Fax: 920-751-8676 | |
Charles Hejny, MD Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 200 Theda Clark Plaza, Suite 110, Neenah, WI 54956 Phone: 920-751-8666 Fax: 920-751-8676 |