| Wautoma Eye Clinic S.c. | |
|
N2577 Plaza Rd, Wautoma, WI 54982-7706 | |
| (920) 787-3837 | |
| (920) 787-1613 |
| Full Name | Wautoma Eye Clinic S.c. |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | N2577 Plaza Rd, Wautoma, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972628584 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 2056 (Wisconsin) | Primary |
| Provider Name | Brian L Meckelberg |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1013993393 PECOS PAC ID: 3678769759 Enrollment ID: I20101201000782 |
| Mailing Address | Practice Location Address |
|---|---|
| Wautoma Eye Clinic S.c. Po Box 366, N2577 Plaza Road, Wautoma, WI 54982-0366 Ph: (920) 787-3837 | Wautoma Eye Clinic S.c. N2577 Plaza Rd, Wautoma, WI 54982-7706 Ph: (920) 787-3837 |
Dr. Brian L Meckelberg, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: N2577 Plaza Rd, Wautoma, WI 54982 Phone: 920-787-3837 Fax: 920-787-1613 | |
Dr. Eric Richard Tyler, O. D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: N2577 Plaza Rd # Wi-73, Wautoma, WI 54982 Phone: 651-206-2418 Fax: 651-206-2418 | |
Wisconsin Optometric Eye Doctor, Inc. Optometrist Medicare: Not Enrolled in Medicare Practice Location: N2577 Plaza Rd # Wi-73, Wautoma, WI 54982 Phone: 920-787-3837 |