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23 W Scott St Fond Du Lac WI 54935-2342 | |
| (920) 926-0101 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 23 W Scott St, Fond Du Lac, Wisconsin |
| Authorized Official Name and Position | Cindy Gaither (VP REVENUE CYCLE MGMT) |
| Authorized Official Contact | 6022488886 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
8444 N 90th St Ste 100 Scottsdale AZ 85258-4437 Ph: (602) 248-8886 | 23 W Scott St Fond Du Lac WI 54935-2342 Ph: (920) 926-0101 |
| NPI Number | 1346620952 |
|---|---|
| Provider Enumeration Date | 06/09/2015 |
| Last Update Date | 02/10/2024 |
| Certification Date | 02/10/2024 |
| Medicare PECOS PAC ID | 5799114195 |
|---|---|
| Medicare Enrollment ID | O20200407000446 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346620952 | NPI | - | NPPES |
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