| Dr Jeffrey Lemoine Dunham, MD | |
|
113 4th Avenue, Shell Lake, WI 54871 | |
| (715) 468-7833 | |
| (715) 468-7839 |
| Full Name | Dr Jeffrey Lemoine Dunham |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 38 Years |
| Location | 113 4th Avenue, Shell Lake, Wisconsin |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841295862 | NPI | - | NPPES |
| 31592800 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 30726 (Wisconsin) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Indianhead Medical Ctr | Shell lake, WI | Hospital |
| Spooner Health System | Spooner, WI | Hospital |
| North Memorial Health | Robbinsdale, MN | Hospital |
| Shell Lake Health Care Center | Shell lake, WI | Nursing home |
| Maple Ridge Care Center | Spooner, WI | Nursing home |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Indianhead Medical Center Shell Lake, Inc. | 6406748839 | 6 |
| Entity Name | Spooner Health System Inc |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1518982628 PECOS PAC ID: 2062310287 Enrollment ID: O20070524000677 |
| Entity Name | Indianhead Medical Center Shell Lake, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1053859058 PECOS PAC ID: 6406748839 Enrollment ID: O20170331000695 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Jeffrey Lemoine Dunham, MD 113 4th Avenue, Shell Lake, WI 54871 Ph: (715) 468-7833 | Dr Jeffrey Lemoine Dunham, MD 113 4th Avenue, Shell Lake, WI 54871 Ph: (715) 468-7833 |
Dr. Allan Jay Haesemeyer, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 113 4th Avenue, Shell Lake, WI 54871 Phone: 715-468-7833 Fax: 715-468-7839 |