| Elkhorn Family Clinic | |
|
100 S Washington St Elkhorn WI 53121-1732 | |
| (262) 743-1122 | |
| (262) 743-1582 |
| Full Name | Elkhorn Family Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 100 S Washington St, Elkhorn, Wisconsin |
| Authorized Official Name and Position | Kamal Syed Muzaffar (CEO) |
| Authorized Official Contact | 2627431122 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elkhorn Family Clinic 100 S Washington St Elkhorn WI 53121-1732 Ph: (262) 743-1122 | Elkhorn Family Clinic 100 S Washington St Elkhorn WI 53121-1732 Ph: (262) 743-1122 |
| NPI Number | 1164637492 |
|---|---|
| Provider Enumeration Date | 05/11/2007 |
| Last Update Date | 04/10/2019 |
| Medicare PECOS PAC ID | 1153598636 |
|---|---|
| Medicare Enrollment ID | O20120124000842 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164637492 | NPI | - | NPPES |
| 34151600 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 305S00000X | Point Of Service | 43819-020 (Wisconsin) | Secondary |
| Provider Name | Kamal S Muzaffar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174599500 PECOS PAC ID: 6709856172 Enrollment ID: I20040731000210 |
| Provider Name | Sandra K Arens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528318870 PECOS PAC ID: 3476774076 Enrollment ID: I20160126002590 |
County Of Walworth Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1910 County Road Nn, Elkhorn, WI 53121 Phone: 262-741-3200 Fax: 262-741-3217 | |
County Of Walworth Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1910 County Road Nn, Elkhorn, WI 53121 Phone: 262-741-3200 Fax: 262-741-3217 |