Robert H Mikkelsen, MD | |
420 E Division St, Fond Du Lac, WI 54935-4560 | |
(920) 926-8485 | |
Not Available |
Full Name | Robert H Mikkelsen |
---|---|
Gender | Male |
Speciality | Surgery |
Location | 420 E Division St, Fond Du Lac, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1851373641 | NPI | - | NPPES |
31076000 | Medicaid | WI | |
020048727 | Other | WI | RAILROAD MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208600000X | Surgery | 20061 (Wisconsin) | Primary |
Entity Name | Divine Savior Healthcare Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1124083894 PECOS PAC ID: 5799684007 Enrollment ID: O20040225000909 |
Mailing Address | Practice Location Address |
---|---|
Robert H Mikkelsen, MD 420 E Division St, Fond Du Lac, WI 54935-4560 Ph: (920) 926-8485 | Robert H Mikkelsen, MD 420 E Division St, Fond Du Lac, WI 54935-4560 Ph: (920) 926-8485 |
Lutti Penton, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 420 E Division St, Fond Du Lac, WI 54935 Phone: 920-926-8614 | |
Christopher A Nervi, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 420 E Division St, Fond Du Lac, WI 54935 Phone: 920-926-8485 | |
Jon T Moen, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 421 Camelot Dr, Fond Du Lac, WI 54935 Phone: 920-926-5760 | |
Donald F Vanbeek, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 210 Wisconsin American Dr, Ste #265, Fond Du Lac, WI 54935 Phone: 920-907-7400 Fax: 920-907-7401 | |
Joanne F Pasiuk, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 420 E Division St, Fond Du Lac, WI 54935 Phone: 920-926-8485 | |
Richard B Schaefer, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 421 Camelot Dr, Fond Du Lac, WI 54935 Phone: 920-926-8614 | |
Thomas J Carlson, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 145 N Main St, Fond Du Lac, WI 54935 Phone: 920-926-8492 |