Edwin M Overholt, MD | |
1836 South Ave, La Crosse, WI 54601-5429 | |
(608) 782-7300 | |
Not Available |
Full Name | Edwin M Overholt |
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Gender | Male |
Speciality | Otolaryngology - Otolaryngology/facial Plastic Surgery |
Location | 1836 South Ave, La Crosse, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1073515342 | NPI | - | NPPES |
31808900 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207YX0905X | Otolaryngology - Otolaryngology/facial Plastic Surgery | 33104 (Wisconsin) | Primary |
Entity Name | Gundersen Clinic Ltd |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1851343115 PECOS PAC ID: 9638082779 Enrollment ID: O20031106000139 |
Entity Name | Gundersen Lutheran Medical Center Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1376593442 PECOS PAC ID: 2163331414 Enrollment ID: O20130619000254 |
Mailing Address | Practice Location Address |
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Edwin M Overholt, MD 1836 South Ave, La Crosse, WI 54601-5429 Ph: (608) 782-7300 | Edwin M Overholt, MD 1836 South Ave, La Crosse, WI 54601-5429 Ph: (608) 782-7300 |
Scott B Blanke, MD Otolaryngology Medicare: Not Enrolled in Medicare Practice Location: 800 West Ave S, La Crosse, WI 54601 Phone: 608-392-9888 Fax: 608-392-9888 | |
Dr. Mark James Ringstrom, M.D. Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 1836 South Ave, La Crosse, WI 54601 Phone: 608-782-7300 | |
Steven L Overholt, MD Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 1836 South Ave, La Crosse, WI 54601 Phone: 608-782-7300 | |
Courtney Brynn Tipton, MD Otolaryngology Medicare: Medicare Enrolled Practice Location: 1836 South Ave, La Crosse, WI 54601 Phone: 608-782-7300 | |
Matthew T Sdano, MD Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 1836 South Ave, La Crosse, WI 54601 Phone: 608-782-7300 | |
Michael D Redman, MD Otolaryngology Medicare: Medicare Enrolled Practice Location: 1836 South Ave, La Crosse, WI 54601 Phone: 608-782-7300 |