| Wisconsin Heights Clinic | |
|
506 Crocker St Ste 3 Mazomanie WI 53560-9426 | |
| (608) 795-4110 | |
| Not Available |
| Full Name | Wisconsin Heights Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 506 Crocker St Ste 3, Mazomanie, Wisconsin |
| Authorized Official Name and Position | James Dregney (CFO) |
| Authorized Official Contact | 6086437212 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wisconsin Heights Clinic 506 Crocker St Ste 3 Mazomanie WI 53560-9426 Ph: (608) 795-4110 | Wisconsin Heights Clinic 506 Crocker St Ste 3 Mazomanie WI 53560-9426 Ph: (608) 795-4110 |
| NPI Number | 1073588299 |
|---|---|
| Provider Enumeration Date | 02/21/2006 |
| Last Update Date | 08/14/2023 |
| Medicare PECOS PAC ID | 8224948054 |
|---|---|
| Medicare Enrollment ID | O20231023000837 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073588299 | NPI | - | NPPES |
| CD3549 | Other | RAILROAD MEDICARE | |
| 32764200 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Secondary |