| (inactive) Marshfield Medical Center - Beaver Dam Horicon Center (hopd | |
|
610 Washington St Horicon WI 53032 | |
| (920) 643-7170 | |
| (920) 643-7165 |
| Full Name | (inactive) Marshfield Medical Center - Beaver Dam Horicon Center (hopd |
|---|---|
| Speciality | Family Medicine |
| Location | 610 Washington St, Horicon, Wisconsin |
| Authorized Official Name and Position | Gordon T Edwards (CFO/COO/AO) |
| Authorized Official Contact | 7153875823 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| (inactive) Marshfield Medical Center - Beaver Dam Horicon Center (hopd 1000 N Oak Ave Attn: Provider Enrollment Services/wwp Marshfield WI 54449-5703 Ph: (715) 389-0660 | (inactive) Marshfield Medical Center - Beaver Dam Horicon Center (hopd 610 Washington St Horicon WI 53032 Ph: (920) 643-7170 |
| NPI Number | 1689915209 |
|---|---|
| Provider Enumeration Date | 03/06/2013 |
| Last Update Date | 03/03/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689915209 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 851-800 (Wisconsin) | Primary |