| Medvidi Health | |
|
N168w20379 Main St # 1008 Jackson WI 53037-9370 | |
| (504) 414-5095 | |
| Not Available |
| Full Name | Medvidi Health |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | N168w20379 Main St # 1008, Jackson, Wisconsin |
| Authorized Official Name and Position | Laura E Purdy (CEO) |
| Authorized Official Contact | 9106448373 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Medvidi Health 4010 Moorpark Ave Ste 114 San Jose CA 95117-1804 Ph: (415) 966-0848 | Medvidi Health N168w20379 Main St # 1008 Jackson WI 53037-9370 Ph: (504) 414-5095 |
| NPI Number | 1245089838 |
|---|---|
| Provider Enumeration Date | 05/15/2024 |
| Last Update Date | 05/15/2024 |
| Certification Date | 05/15/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245089838 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
Wisconsin Lutheran Child & Family Service Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3399 Division Rd, Jackson, WI 53037 Phone: 800-438-1772 Fax: 262-293-9737 |