Michael R Magoline, MD | |
421 Camelot Dr, Fond Du Lac, WI 54935-8335 | |
(920) 926-8616 | |
(920) 926-8098 |
Full Name | Michael R Magoline |
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Gender | Male |
Speciality | Orthopaedic Surgery |
Location | 421 Camelot Dr, Fond Du Lac, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1154412302 | NPI | - | NPPES |
2187002 | Medicaid | OH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207X00000X | Orthopaedic Surgery | 35-071501 (Ohio) | Secondary |
207X00000X | Orthopaedic Surgery | 82106-20 (Wisconsin) | Primary |
Entity Name | Michael R Magoline Md Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1063146272 PECOS PAC ID: 0345134219 Enrollment ID: O20221020001817 |
Mailing Address | Practice Location Address |
---|---|
Michael R Magoline, MD 1808 W Beltline Hwy, Ssm Health Fdlregional Clinic Attn: Nancy Pierce, Madison, WI 53713-2334 Ph: (920) 926-8343 | Michael R Magoline, MD 421 Camelot Dr, Fond Du Lac, WI 54935-8335 Ph: (920) 926-8616 |
Alan W Roetker, MD Orthopedic Surgery Medicare: Not Enrolled in Medicare Practice Location: 421 Camelot Dr, Fond Du Lac, WI 54935 Phone: 920-926-8616 | |
Benjamin Richard Wiseley, M.D. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 421 Camelot Dr, Fond Du Lac, WI 54935 Phone: 920-926-8616 | |
Glen J Kemp Jr., MD Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 421 Camelot Dr, Fond Du Lac, WI 54935 Phone: 920-926-8616 Fax: 920-926-8098 | |
Karl Pennau, MD Orthopedic Surgery Medicare: Not Enrolled in Medicare Practice Location: 421 Camelot Dr, Fond Du Lac, WI 54935 Phone: 920-926-8616 | |
Michael D Mannebach, MD Orthopedic Surgery Medicare: Not Enrolled in Medicare Practice Location: 421 Camelot Dr, Fond Du Lac, WI 54935 Phone: 920-926-8616 | |
Dr. Clark Pomeroy Searle Iii, MD Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 421 Camelot Dr, Fond Du Lac, WI 54935 Phone: 920-926-8616 |