Eye Centers Of Racine And Kenosha Ltd | |
3805b Spring St Ste 140, Mount Pleasant, WI 53405-1642 | |
(262) 637-8835 | |
(262) 635-8027 |
Full Name | Eye Centers Of Racine And Kenosha Ltd |
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Type | Facility |
Speciality | Ophthalmology |
Location | 3805b Spring St Ste 140, Mount Pleasant, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1710905781 | NPI | - | NPPES |
38713800 | Medicaid | WI | |
0631860001 | Other | WI | NGS ADMINISTAR |
100202317 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
207W00000X | Ophthalmology | (* (Not Available)) | Primary |
Provider Name | Inder P Singh |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1063430023 PECOS PAC ID: 0244291375 Enrollment ID: I20041022000140 |
Provider Name | Stephen J Pruett |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1427070259 PECOS PAC ID: 1052509221 Enrollment ID: I20110103000962 |
Provider Name | Radha K Sanka |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1508042060 PECOS PAC ID: 8325179518 Enrollment ID: I20120507000210 |
Provider Name | Jeff R Banas |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1619328606 PECOS PAC ID: 4688968266 Enrollment ID: I20160804000423 |
Provider Name | Jessica G Schiffbauer |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1659723328 PECOS PAC ID: 3678851367 Enrollment ID: I20220425002392 |
Mailing Address | Practice Location Address |
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Eye Centers Of Racine And Kenosha Ltd 3805b Spring St, Suite 140, Racine, WI 53405-1641 Ph: (262) 637-0500 | Eye Centers Of Racine And Kenosha Ltd 3805b Spring St Ste 140, Mount Pleasant, WI 53405-1642 Ph: (262) 637-8835 |