| Dr Mark A Clemence, MD | |
|
6080 S 108th St, Hales Corners, WI 53130-2557 | |
| (414) 425-5351 | |
| (414) 529-6350 |
| Full Name | Dr Mark A Clemence |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine |
| Experience | 40 Years |
| Location | 6080 S 108th St, Hales Corners, 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 |
|---|---|---|---|
| 1255324216 | NPI | - | NPPES |
| 045668480 | Other | WI | MEDICARE PTAN |
| 049873840 | Other | WI | MEDICARE PTAN |
| 32081200 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 34043 (Wisconsin) | Primary |
| 207RI0200X | Internal Medicine - Infectious Disease | 34043 (Wisconsin) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Ascension At Home | Milwaukee, WI | Home health agency |
| Aurora At Home | Milwaukee, WI | Home health agency |
| Recover Health Of Wisconsin, Inc | Brookfield, WI | Home health agency |
| Ascension Se Wisconsin Hospital - St Joseph Campus | Milwaukee, WI | Hospital |
| Ascension St Francis Hospital | Milwaukee, WI | Hospital |
| Midwest Orthopedic Specialty Hospital | Franklin, WI | Hospital |
| West Allis Memorial Hospital | West allis, WI | Hospital |
| Waukesha Memorial Hospital | Waukesha, WI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Ascension Medical Group-southeast Wisconsin Inc | 8628980943 | 561 |
| Entity Name | Ascension Medical Group-southeast Wisconsin Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1609881077 PECOS PAC ID: 8628980943 Enrollment ID: O20031104000421 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Mark A Clemence, MD Po Box 689711, Milwaukee, WI 53268-9711 Ph: (414) 456-3100 | Dr Mark A Clemence, MD 6080 S 108th St, Hales Corners, WI 53130-2557 Ph: (414) 425-5351 |