| Chn Medical Center Ripon | |
|
1080 W Fond Du Lac St Ripon WI 54971-9286 | |
| (920) 748-7000 | |
| (920) 748-7236 |
| Full Name | Chn Medical Center Ripon |
|---|---|
| Speciality | Family Medicine |
| Location | 1080 W Fond Du Lac St, Ripon, Wisconsin |
| Authorized Official Name and Position | Steven Ruedinger (VICE PRESIDENT) |
| Authorized Official Contact | 9203615988 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Chn Medical Center Ripon Po Box 307 Ripon WI 54971-0307 Ph: (920) 748-7000 | Chn Medical Center Ripon 1080 W Fond Du Lac St Ripon WI 54971-9286 Ph: (920) 748-7000 |
| NPI Number | 1003115064 |
|---|---|
| Provider Enumeration Date | 03/16/2011 |
| Last Update Date | 06/12/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003115064 | NPI | - | NPPES |
| 11011000 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 20430 (Wisconsin) | Primary |
Thedacare, Incorporated Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1080 W Fond Du Lac St, Ripon, WI 54971 Phone: 920-748-7000 Fax: 920-748-7236 |