BRIAN T PERKOVICH


Address: 2253 W Mason St Ste 100, Green Bay, WI 54303-4706
Phone: 9203277000

BRIAN T PERKOVICH (NPI# 1558381632) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1558381632
Entity Type Individual
Full Name BRIAN T PERKOVICH
Credential MD
Practice Address 2253 W Mason St Ste 100
Green Bay
WI 54303-4706
Mailing Address 164 N Broadway
Green Bay
WI 54303-2728
Practice Telephone 9203277000
Practice Fax Number 9203277005
Mailing Telephone 9204909046
Mailing Fax Number 9203277005
Enumeration Date 2006-07-20
Last Update Date 2017-11-20
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207W00000X Ophthalmology 30965 WI Allopathic & Osteopathic Physicians
Y 207WX0107X Ophthalmology
Specialization: Retina Specialist
30965 WI Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
WI 31603100 05

Office Location

Street Address 2253 W MASON ST STE 100
City GREEN BAY
State WI
Zip Code 54303-4706

Providers in the same location

NPI Name Taxonomy Address Enumeration
1790720100 Dianna L Bordewick Ophthalmology 2253 W Mason St Ste 100, Green Bay, WI 54303-4706 2006-06-19
1497220107 Linda Thieme Technician/Technologist 2253 W Mason St Ste 100, Green Bay, WI 54303-4706 2018-10-09
1306075635 Jacob A Kozisek Optometrist 2253 W Mason St Ste 100, Green Bay, WI 54303-4706 2009-07-08
1265623649 Joseph Thomas Bergmann Ophthalmology 2253 W Mason St Ste 100, Green Bay, WI 54303-4706 2007-08-09
1932218005 Wei-chuan Wang Ophthalmology 2253 W Mason St Ste 100, Green Bay, WI 54303-4706 2006-08-30
1003828740 Brad J Lavallie Optometrist 2253 W Mason St Ste 100, Green Bay, WI 54303-4706 2006-08-12
1144241852 Kevin P Wienkers Ophthalmology 2253 W Mason St Ste 100, Green Bay, WI 54303-4706 2006-07-21
1790702652 Kirk D Scattergood Ophthalmology 2253 W Mason St Ste 100, Green Bay, WI 54303-4706 2006-07-16
1235167537 Mark T Duffy Ophthalmology 2253 W Mason St Ste 100, Green Bay, WI 54303-4706 2006-06-28
1568490829 William J Foster Ophthalmology 2253 W Mason St Ste 100, Green Bay, WI 54303-4706 2006-06-28
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1952921033 Ashley Marie Vandermoss Social Worker 1601 W Mason Street, Green Bay, WI 54303 2020-04-20
1598307423 Jean Marie Castaneda Case Manager/Care Coordinator 2517 N. Court, Green Bay, WI 54303 2019-10-11
1215579552 Integrated Treatment Centers, LLC Clinic/Center 2311 W Mason Street, Green Bay, WI 54303 2019-10-08
1003460551 Affordable Dentures & Implants - Green Bay, S.c. Dentist 1800-c W. Mason Street, Green Bay, WI 54303 2019-08-01
1164940375 Kaeley Rae Blaney Student in an Organized Health Care Education/Training Program 2088 Memorial Drive #208, Green Bay, WI 54303 2017-09-07
1518498047 Treatment Providers LLC Clinic/Center 2731 N Packerland Dr Ste A, Green Bay, WI 54303 2017-03-26
1851840565 Back To Balance Chiropractic, LLC Chiropractor 110 Packerland Drive, Suite B, Green Bay, WI 54303 2016-09-23
1710361001 Matthew Lemay Acupuncturist 727 E Walnut, Suite B2, Green Bay, WI 54303 2015-07-16
1144600149 Carrie Jean Banaszak Counselor 1039 Mason Street, Green Bay, WI 54303 2015-06-04
1174921993 Kensey Meyer Occupational Therapy Assistant 1555 Dousman Road, Seymour, WI 54303 2014-12-10
Find all providers in zip 54303

Taxonomy Information

Taxonomy Code 207WX0107X
Grouping Allopathic & Osteopathic Physicians
Classification Ophthalmology
Specialization Retina Specialist

Taxonomy Definition

An ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases.
Notes: Source: American Society of Retina Specialists, www.asrs.org [1/1/2017: new]
- Additional Resources: American Academy of Ophthalmology, www.aao.org. Macula Society, www.maculasociety.org. Retina Society, www.retinasociety.org. Association of University Professors of Ophthalmology, www.aupo.org.

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1811253289 Michael Edward Possin Ophthalmology 200 Theda Clark Medical Plz Ste 110, Neenah, WI 54956-2790 2012-04-10
1437164175 Northeast Wisconsin Retina Associates Sc Ophthalmology 200 Theda Clark Plaza, Suite 110, Neenah, WI 54956-2790 2006-07-30
1700819281 Rajeev Buddi Ophthalmology 200 Theda Clark Pl, Suite 110, Neenah, WI 54956 2006-07-08
1356640726 Khalid S Kahook Ophthalmology 200 Theda Clark Plaza, Suite 110, Neenah, WI 54956-2790 2011-03-24
1679580070 John P Rosculet Ophthalmology 200 Theda Clark Plaza, Suite 110, Neenah, WI 54956 2006-08-01
1922013671 Charles Hejny Ophthalmology 200 Theda Clark Plaza, Suite 110, Neenah, WI 54956 2006-07-30

Competitor

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City GREEN BAY
Zip Code 54303

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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