Robert John Blanco, MD | |
855 N Westhaven Dr, Oshkosh, WI 54904-7668 | |
(920) 303-8700 | |
(920) 303-8993 |
Full Name | Robert John Blanco |
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Gender | Male |
Speciality | Preventive Medicine - Occupational Medicine |
Location | 855 N Westhaven Dr, Oshkosh, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1316272099 | NPI | - | NPPES |
100075672 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | 52680-20 (Wisconsin) | Secondary |
2083X0100X | Preventive Medicine - Occupational Medicine | 52680-020 (Wisconsin) | Primary |
Entity Name | Aurora Medical Group, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1427271378 PECOS PAC ID: 6709794258 Enrollment ID: O20031105000725 |
Mailing Address | Practice Location Address |
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Robert John Blanco, MD 855 N Westhaven Dr, Oshkosh, WI 54904-7668 Ph: (920) 303-8700 | Robert John Blanco, MD 855 N Westhaven Dr, Oshkosh, WI 54904-7668 Ph: (920) 303-8700 |
Dr. Timothy Bergan, D.O. Preventive Medicine Medicare: Medicare Enrolled Practice Location: 855 N Westhaven Dr, Oshkosh, WI 54904 Phone: 920-303-8700 | |
Dr. Azadeh Farokhi, M.D. Preventive Medicine Medicare: Medicare Enrolled Practice Location: 855 N Westhaven Dr, Oshkosh, WI 54904 Phone: 920-303-8700 Fax: 920-456-5590 | |
Tierney Fritz, Preventive Medicine Medicare: Not Enrolled in Medicare Practice Location: 1855 S Koeller St, Oshkosh, WI 54902 Phone: 920-223-7000 |