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1505 Mill St New London WI 54961-2187 | |
(920) 982-7900 | |
(920) 982-7995 |
Full Name | |
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Speciality | Family Medicine |
Location | 1505 Mill St, New London, Wisconsin |
Authorized Official Name and Position | Brian L Van Hoozen (OWNER) |
Authorized Official Contact | 9209827900 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1505 Mill St New London WI 54961-2187 Ph: (920) 982-7900 | 1505 Mill St New London WI 54961-2187 Ph: (920) 982-7900 |
NPI Number | 1144673039 |
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Provider Enumeration Date | 07/15/2016 |
Last Update Date | 07/15/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1144673039 | NPI | - | NPPES |
30054700 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 3269921 (Wisconsin) | Primary |
Brian Van Hoozen Do Sc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1505 Mill St, New London, WI 54961 Phone: 920-982-7900 Fax: 920-982-7995 |