| Fmc Kewaunee | |
|
575 4th St Kewaunee WI 54216-1785 | |
| (920) 388-4640 | |
| Not Available |
| Full Name | Fmc Kewaunee |
|---|---|
| Speciality | Clinic/Center |
| Location | 575 4th St, Kewaunee, Wisconsin |
| Authorized Official Name and Position | Denise K Stroobants (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 9204337864 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fmc Kewaunee 575 4th St Kewaunee WI 54216-1785 Ph: (920) 388-4640 | Fmc Kewaunee 575 4th St Kewaunee WI 54216-1785 Ph: (920) 388-4640 |
| NPI Number | 1699737379 |
|---|---|
| Provider Enumeration Date | 04/06/2006 |
| Last Update Date | 10/18/2021 |
| Medicare PECOS PAC ID | 8820900749 |
|---|---|
| Medicare Enrollment ID | O20050909000116 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699737379 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Lakeshore Vision Centers Ltd Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1217 Ellis St, Kewaunee, WI 54216 Phone: 920-388-2020 Fax: 920-388-3594 |