| Ascensoin Medical Group | |
|
614 Memorial Dr Chilton WI 53014 | |
| (920) 849-3800 | |
| Not Available |
| Full Name | Ascensoin Medical Group |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 614 Memorial Dr, Chilton, Wisconsin |
| Authorized Official Name and Position | J. Bryan Fissel (VP-FINANCE) |
| Authorized Official Contact | 4144653000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ascensoin Medical Group 614 Memorial Dr Chilton WI 53014-1568 Ph: (920) 738-2000 | Ascensoin Medical Group 614 Memorial Dr Chilton WI 53014 Ph: (920) 849-3800 |
| NPI Number | 1700039880 |
|---|---|
| Provider Enumeration Date | 11/03/2008 |
| Last Update Date | 03/27/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700039880 | NPI | - | NPPES |
| 32752000 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
Ascension Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 618 Memorial Dr, Chilton, WI 53014 Phone: 920-849-3800 |