| Ryan T Zantow, MD | |
|
855 N Westhaven Dr, Oshkosh, WI 54904-7668 | |
| (833) 986-2170 | |
| Not Available |
| Full Name | Ryan T Zantow |
|---|---|
| Gender | Male |
| Speciality | Preventive Medicine - Occupational Medicine |
| Location | 855 N Westhaven Dr, Oshkosh, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821044892 | NPI | - | NPPES |
| 34827700 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208100000X | Physical Medicine & Rehabilitation | 44776-020 (Wisconsin) | Secondary |
| 2083X0100X | Preventive Medicine - Occupational Medicine | 44776 (Wisconsin) | Primary |
| Entity Name | Aurora Medical Group, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1427271378 PECOS PAC ID: 6709794258 Enrollment ID: O20031105000725 |
| Mailing Address | Practice Location Address |
|---|---|
| Ryan T Zantow, MD Po Box 735044, Chicago, IL 60673-5044 Ph: (800) 326-2250 | Ryan T Zantow, MD 855 N Westhaven Dr, Oshkosh, WI 54904-7668 Ph: (833) 986-2170 |
Dr. Timothy Bergan, D.O. Preventive Medicine Medicare: Not Enrolled in Medicare Practice Location: 855 N Westhaven Dr, Oshkosh, WI 54904 Phone: 920-303-8700 |
Robert John Blanco, M.D. Preventive Medicine Medicare: Accepting Medicare Assignments Practice Location: 855 N Westhaven Dr, Oshkosh, WI 54904 Phone: 920-303-8700 Fax: 920-303-8993 |
Dr. Azadeh Farokhi, M.D. Preventive Medicine Medicare: Not Enrolled in Medicare Practice Location: 855 N Westhaven Dr, Oshkosh, WI 54904 Phone: 920-303-8700 Fax: 920-456-5590 |