| Family Health Center/marshfield Clinic Dental Centers | |
|
1307 N Saint Joseph Ave Marshfield WI 54449-1340 | |
| (715) 221-5600 | |
| Not Available |
| Full Name | Family Health Center/marshfield Clinic Dental Centers |
|---|---|
| Speciality | Clinic/Center |
| Location | 1307 N Saint Joseph Ave, Marshfield, Wisconsin |
| Authorized Official Name and Position | Gregory R. Nycz (DIRECTOR OF FAMILY HEALTH CENTER) |
| Authorized Official Contact | 7153879137 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Health Center/marshfield Clinic Dental Centers 1000 N Oak Ave Provider Enrollment Services - Wwp Marshfield WI 54449-5703 Ph: (715) 898-6208 | Family Health Center/marshfield Clinic Dental Centers 1307 N Saint Joseph Ave Marshfield WI 54449-1340 Ph: (715) 221-5600 |
| NPI Number | 1437264140 |
|---|---|
| Provider Enumeration Date | 08/20/2006 |
| Last Update Date | 04/05/2022 |
| Medicare PECOS PAC ID | 2466540877 |
|---|---|
| Medicare Enrollment ID | O20071119000591 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437264140 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| Provider Name | Richard J Wilkinson |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1386751543 PECOS PAC ID: 0749194041 Enrollment ID: I20071119000633 |
| Provider Name | Paula M Hensel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093825242 PECOS PAC ID: 3173556263 Enrollment ID: I20100618000757 |
| Provider Name | Sumeet K Goel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073824470 PECOS PAC ID: 2163663691 Enrollment ID: I20130726000147 |
| Provider Name | Sheila Heiser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891209664 PECOS PAC ID: 4789944851 Enrollment ID: I20180209001464 |
| Provider Name | Deepak K Neelagiri |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1093026791 PECOS PAC ID: 2264697721 Enrollment ID: I20190305000082 |
| Provider Name | Danyelle A Hasz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144870239 PECOS PAC ID: 2567794076 Enrollment ID: I20191104001019 |
| Provider Name | Suzanne M Blimling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366018558 PECOS PAC ID: 0143625244 Enrollment ID: I20210827002181 |
| Provider Name | Krista Michele Radish |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669179552 PECOS PAC ID: 3779949383 Enrollment ID: I20230523002358 |
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