| Chn Medical Center Green Lake | |
|
670 County Road A Green Lake WI 54941 | |
| (920) 294-0100 | |
| (920) 294-0123 |
| Full Name | Chn Medical Center Green Lake |
|---|---|
| Speciality | Family Medicine |
| Location | 670 County Road A, Green Lake, Wisconsin |
| Authorized Official Name and Position | Thomas Krystowiak (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 9203611313 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Chn Medical Center Green Lake 670 County Road A Green Lake WI 54941 Ph: (920) 294-0100 | Chn Medical Center Green Lake 670 County Road A Green Lake WI 54941 Ph: (920) 294-0100 |
| NPI Number | 1568622280 |
|---|---|
| Provider Enumeration Date | 06/16/2008 |
| Last Update Date | 05/02/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568622280 | NPI | - | NPPES |
| 21329400 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 44378 (Wisconsin) | Primary |
Green Lake Medical Clinic , S.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: N6205 Busse Drive, Green Lake, WI 54941 Phone: 920-294-3444 Fax: 920-294-6660 | |
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Active Family Chiropractic Center Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 610 South St, Green Lake, WI 54941 Phone: 920-229-7215 |