| Door County Medical Center Sturgeon Bay | |
|
323 S 18th Ave Sturgeon Bay WI 54235-1401 | |
| (920) 743-5566 | |
| Not Available |
| Full Name | Door County Medical Center Sturgeon Bay |
|---|---|
| Speciality | Clinic/Center |
| Location | 323 S 18th Ave, Sturgeon Bay, Wisconsin |
| Authorized Official Name and Position | Andrew S Laluzerne (CFO) |
| Authorized Official Contact | 9207463729 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Door County Medical Center Sturgeon Bay 323 S 18th Ave Sturgeon Bay WI 54235-1401 Ph: (920) 743-5566 | Door County Medical Center Sturgeon Bay 323 S 18th Ave Sturgeon Bay WI 54235-1401 Ph: (920) 743-5566 |
| NPI Number | 1578892857 |
|---|---|
| Provider Enumeration Date | 12/15/2009 |
| Last Update Date | 04/06/2022 |
| Medicare PECOS PAC ID | 5395735088 |
|---|---|
| Medicare Enrollment ID | O20081106000547 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578892857 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Samantha M Prust |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740899285 PECOS PAC ID: 9032584438 Enrollment ID: I20230701000436 |
| Provider Name | Tiffany Johnson-bussberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720496177 PECOS PAC ID: 9638399892 Enrollment ID: I20230815003567 |
| Provider Name | Jared Laverne Harwood |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1942393954 PECOS PAC ID: 7113161225 Enrollment ID: I20240508000561 |
Community Clinic Of Door County, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1623 Rhode Island St, Sturgeon Bay, WI 54235 Phone: 920-746-8989 Fax: 920-746-8960 | |
Door County Memorial Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 323 S 18th Ave, Sturgeon Bay, WI 54235 Phone: 920-743-5566 | |
Directcare Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 911 Green Bay Rd Ste 103, Sturgeon Bay, WI 54235 Phone: 920-746-4565 |