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Contact Information

KIVLIN EYE CLINIC, SC
370 3RD AVE
CLEAR LAKE, WI54005
 Phone: 715-263-2600
 Fax: 715-263-3233
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for KIVLIN EYE CLINIC, SC

NPI # 1952595480
LBN Legal business name KIVLIN EYE CLINIC, SC
Authorized official JAMES KIVLIN - (OWNER/OPTOMETRIST)
Entity Organization
Organization subpart 1 No
Enumeration date 08/28/2007
Last updated 08/31/2009 - About 17 years ago
Identifiers
WI License # 1539-035
WI Medicaid 38702400
WI Other 0523040002 DMERC
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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