| Dr Thomas Anthony Licata, DO | |
| 
					333 Pine Ridge Blvd, Wausau, WI 54401-4102  | |
| (715) 675-3391 | |
| Not Available | 
| Full Name | Dr Thomas Anthony Licata | 
|---|---|
| Gender | Male | 
| Speciality | Family Medicine | 
| Location | 333 Pine Ridge Blvd, Wausau, Wisconsin | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1427638659 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207Q00000X | Family Medicine | 81059-21 (Wisconsin) | Primary | 
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary | 
| Entity Name | Aspirus Wausau Hospital Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1922321140 PECOS PAC ID: 6406757442 Enrollment ID: O20040114000297  | 
| Entity Name | Aspirus Medford Hospital & Clinics Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1285703173 PECOS PAC ID: 5799688602 Enrollment ID: O20040129000007  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Dr Thomas Anthony Licata, DO 333 Pine Ridge Blvd, Wausau, WI 54401-4102 Ph: () -  | Dr Thomas Anthony Licata, DO 333 Pine Ridge Blvd, Wausau, WI 54401-4102 Ph: (715) 675-3391  | 
Melanie A Hellrood, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 2720 Plaza Dr Ste 1300, Wausau, WI 54401 Phone: 715-847-2630  | |
Dr. Jonathan Joseph Cotter, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 3110 Glendale Ave, Wausau, WI 54401 Phone: 715-845-8891 Fax: 715-845-8891  | |
Lindsey Sippl, AGPCNP-BC Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1111 Westwood Dr, Wausau, WI 54401 Phone: 715-952-1029 Fax: 715-304-3682  | |
Adam G Clements, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 425 Wind Ridge Dr, Wausau, WI 54401 Phone: 715-675-3391 Fax: 715-675-4253  | |
Saba Khan, DO Family Medicine Medicare: Medicare Enrolled Practice Location: 425 Wind Ridge Dr, Wausau, WI 54401 Phone: 715-675-3391  | |
Lisa Grill Dodson, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 2720 Plaza Dr, Suite 1100, Wausau, WI 54401 Phone: 715-847-2472  | |
John F Webb, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 2727 Plaza Dr, Wausau, WI 54401 Phone: 715-847-3434  |