| Ascension Medical Group-fox Valley Wisconsin, Inc | |
|
1610 Hoover St New Holstein WI 53061 | |
| (920) 849-3800 | |
| Not Available |
| Full Name | Ascension Medical Group-fox Valley Wisconsin, Inc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 1610 Hoover St, New Holstein, Wisconsin |
| Authorized Official Name and Position | J. Bryan Fissel (VP-FINANCE) |
| Authorized Official Contact | 4144653000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ascension Medical Group-fox Valley Wisconsin, Inc 1610 Hoover St New Holstein WI 53061-1636 Ph: (920) 738-2000 | Ascension Medical Group-fox Valley Wisconsin, Inc 1610 Hoover St New Holstein WI 53061 Ph: (920) 849-3800 |
| NPI Number | 1073970984 |
|---|---|
| Provider Enumeration Date | 01/22/2016 |
| Last Update Date | 03/27/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073970984 | NPI | - | NPPES |
| 32752000 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |