Chn Medical Center Wautoma | |
N2934 State Road 22 Wautoma WI 54982-5267 | |
(920) 787-4613 | |
(920) 787-5433 |
Full Name | Chn Medical Center Wautoma |
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Speciality | Family Medicine |
Location | N2934 State Road 22, Wautoma, 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 |
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Chn Medical Center Wautoma Po Box 650 Wautoma WI 54982-0650 Ph: (920) 787-4613 | Chn Medical Center Wautoma N2934 State Road 22 Wautoma WI 54982-5267 Ph: (920) 787-4613 |
NPI Number | 1780973826 |
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Provider Enumeration Date | 03/29/2011 |
Last Update Date | 03/29/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1780973826 | NPI | - | NPPES |
11011000 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 25430 (Wisconsin) | Primary |
Horizon Healthcare, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 719 W Main St, Wautoma, WI 54982 Phone: 414-376-5577 |