| Randy J Mickelson, PA | |
|
407 S Main St, Viroqua, WI 54665-2100 | |
| (608) 637-3195 | |
| Not Available |
| Full Name | Randy J Mickelson |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | 407 S Main St, Viroqua, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255335725 | NPI | - | NPPES |
| 42920800 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 528 (Wisconsin) | Primary |
| Entity Name | Gundersen Clinic Ltd |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1851343115 PECOS PAC ID: 9638082779 Enrollment ID: O20031106000139 |
| Mailing Address | Practice Location Address |
|---|---|
| Randy J Mickelson, PA 1836 South Ave, La Crosse, WI 54601-5429 Ph: (608) 782-7300 | Randy J Mickelson, PA 407 S Main St, Viroqua, WI 54665-2100 Ph: (608) 637-3195 |
Thomas L Franke, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 407 South Main St, Viroqua, WI 54665 Phone: 608-637-4230 Fax: 608-637-4214 |
Beth Ann Winter, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 507 S Main St, Viroqua, WI 54665 Phone: 608-625-2494 |
Jessica Merzenich, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 507 S Main St, Viroqua, WI 54665 Phone: 608-637-2101 |
Mitchell James Winter, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 407 S Main St, Viroqua, WI 54665 Phone: 608-637-3195 |
Craig Aaron Pierce, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 507 S Main St, Viroqua, WI 54665 Phone: 608-637-2101 |
Jane A Domroese, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 407 S Main St, Viroqua, WI 54665 Phone: 608-637-3195 |
Colin J. Kratochwill, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 407 S Main St, Suite 200, Viroqua, WI 54665 Phone: 608-637-3195 |