| Mark C Wickre, MD | |
|
1836 South Ave, La Crosse, WI 54601-5429 | |
| (608) 782-7300 | |
| Not Available |
| Full Name | Mark C Wickre |
|---|---|
| Gender | Male |
| Speciality | Diagnostic Radiology |
| Experience | 11 Years |
| Location | 1836 South Ave, La Crosse, 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 |
|---|---|---|---|
| 1063830628 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 61383 (Minnesota) | Secondary |
| 2085R0202X | Radiology - Diagnostic Radiology | 73555 (Wisconsin) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Gundersen Lutheran Medical Center | La crosse, WI | Hospital |
| St Elizabeth Medical Center | Wabasha, MN | Hospital |
| Gundersen Tri-county Hospital & Clinics | Whitehall, WI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Gundersen Lutheran Medical Center Inc | 2163331414 | 793 |
| Saint Elizabeths Hospital Of Wabasha Inc | 5092619387 | 82 |
| Moundview Memorial Hospital And Clinics, Inc. | 1355250432 | 34 |
| Gundersen Lutheran Medical Center Inc | 2163331414 | 793 |
| Tri-county Memorial Hospital Inc | 4587642418 | 55 |
| Saint Elizabeths Hospital Of Wabasha Inc | 5092619387 | 82 |
| Entity Name | Gundersen Clinic Ltd |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1851343115 PECOS PAC ID: 9638082779 Enrollment ID: O20031113000579 |
| Entity Name | Saint Elizabeths Hospital Of Wabasha Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1659355600 PECOS PAC ID: 5092619387 Enrollment ID: O20031119000811 |
| Entity Name | Gundersen Lutheran Medical Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1376593442 PECOS PAC ID: 2163331414 Enrollment ID: O20130807000951 |
| Mailing Address | Practice Location Address |
|---|---|
| Mark C Wickre, MD 1836 South Ave, La Crosse, WI 54601-5429 Ph: (608) 782-7300 | Mark C Wickre, MD 1836 South Ave, La Crosse, WI 54601-5429 Ph: (608) 782-7300 |
Cameron F Roberts, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 1836 South Ave, La Crosse, WI 54601 Phone: 608-782-7300 | |
Brian R Manske, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 1836 South Ave, La Crosse, WI 54601 Phone: 608-782-7300 | |
Dr. Heather Jo Wichman, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 1900 South Ave, La Crosse, WI 54601 Phone: 608-775-6569 | |
Robert E Wax, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 1836 South Ave, La Crosse, WI 54601 Phone: 608-782-7300 | |
Douglas G Gold, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 1836 South Ave, La Crosse, WI 54601 Phone: 608-782-7300 | |
Dr. Ezana M Azene, MD, PHD Radiology Medicare: Accepting Medicare Assignments Practice Location: 1836 South Ave, La Crosse, WI 54601 Phone: 608-782-7300 |