| Northeast Wisconsin Vision Center, Ltd. | |
|
2130 S Washburn St, Oshkosh, WI 54904-8949 | |
| (920) 232-6550 | |
| (920) 232-6552 |
| Full Name | Northeast Wisconsin Vision Center, Ltd. |
|---|---|
| Type | Facility |
| Speciality | Ophthalmology |
| Location | 2130 S Washburn St, Oshkosh, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295715415 | NPI | - | NPPES |
| 32863800 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (* (Not Available)) | Secondary |
| 207W00000X | Ophthalmology | (* (Not Available)) | Primary |
| Provider Name | Stephen J Merfeld |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1619957230 PECOS PAC ID: 8224082771 Enrollment ID: I20050308000464 |
| Provider Name | Eric M Larson |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1275513467 PECOS PAC ID: 7315026465 Enrollment ID: I20080501000073 |
| Provider Name | Wesley R Meyer |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1396714812 PECOS PAC ID: 0244324390 Enrollment ID: I20110114000618 |
| Provider Name | Paul H Payant |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1003264318 PECOS PAC ID: 5597057224 Enrollment ID: I20160715001720 |
| Provider Name | Jessica D Kulick |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1295186690 PECOS PAC ID: 2365735511 Enrollment ID: I20160726000120 |
| Provider Name | Meisha Raven |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1073975322 PECOS PAC ID: 5496026254 Enrollment ID: I20200620000080 |
| Mailing Address | Practice Location Address |
|---|---|
| Northeast Wisconsin Vision Center, Ltd. Po Box 2723, Oshkosh, WI 54903-2723 Ph: () - | Northeast Wisconsin Vision Center, Ltd. 2130 S Washburn St, Oshkosh, WI 54904-8949 Ph: (920) 232-6550 |