| Vision Source Shawano | |
|
301 W Green Bay St, Shawano, WI 54166-2335 | |
| (715) 524-4997 | |
| (715) 524-4905 |
| Full Name | Vision Source Shawano |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 301 W Green Bay St, Shawano, Wisconsin |
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558583930 | NPI | - | NPPES |
| 38578900 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 2422 (Wisconsin) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Vision Source Shawano 401 Woodward Ave, Kingsford, MI 49802-4630 Ph: (906) 774-0611 | Vision Source Shawano 301 W Green Bay St, Shawano, WI 54166-2335 Ph: (715) 524-4997 |
Mr. William James Stern, O.D. Optometrist Medicare: Medicare Enrolled Practice Location: 153 Woodlawn Dr, Shawano, WI 54166 Phone: 715-524-2553 Fax: 715-524-6383 | |
1 Vision S.c. Optometrist Medicare: Medicare Enrolled Practice Location: 150a County Rd B, Shawano, WI 54166 Phone: 715-526-3163 Fax: 715-526-4019 | |
Dr. Thomas G Peterson, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 150a County Road B, Shawano, WI 54166 Phone: 715-526-3163 Fax: 715-526-4019 | |
Dr. Nicole Jeannine Klotzbuecher, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 150 County Road B, Shawano, WI 54166 Phone: 715-526-3163 | |
Mr. Kavit Lache Beyersdorf, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 150a County Rd B, Shawano, WI 54166 Phone: 715-526-3163 Fax: 715-526-4019 | |
Janson A Mancheski, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 1244 E Green Bay St, Janson Mancheski Od, Shawano, WI 54166 Phone: 715-526-2376 Fax: 715-526-9561 |