NPI 1679688774 · live from the CMS NPI Registry
Mary Katherine Ellis, MD
Ophthalmology in Oconomowoc, WI. National Provider Identifier 1679688774, active.
NPI record
| NPI | 1679688774 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Ophthalmology 207W00000X |
| Practice location | 915 Summit Ave, Oconomowoc, WI 53066 |
| Practice phone | 262-569-2300 |
| Mailing address | 3301 W Forest Home Ave, Milwaukee, WI 53215 |
| Enumerated | August 20, 2006 |
| Last updated | March 7, 2023 |
| Sole proprietor | No |
| Other names | Mary Ellis-Metz |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Ophthalmology primary | 207W00000X | 29428-020 (WI) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.