| Ascension Medical Group | |
|
200 Patriot Dr Little Chute WI 54140 | |
| (920) 687-2800 | |
| Not Available |
| Full Name | Ascension Medical Group |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 200 Patriot Dr, Little Chute, Wisconsin |
| Authorized Official Name and Position | J. Bryan Fissel (VP-FINANCE) |
| Authorized Official Contact | 7153692109 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ascension Medical Group 200 Patriot Dr Little Chute WI 54140-1184 Ph: (920) 738-2000 | Ascension Medical Group 200 Patriot Dr Little Chute WI 54140 Ph: (920) 687-2800 |
| NPI Number | 1043478324 |
|---|---|
| Provider Enumeration Date | 05/23/2008 |
| Last Update Date | 03/27/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043478324 | NPI | - | NPPES |
| 32752000 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |