| Gl Blair Clinic | |
|
420 S Peterson Ave Blair WI 54616-8861 | |
| (608) 782-7300 | |
| Not Available |
| Full Name | Gl Blair Clinic |
|---|---|
| Speciality | Clinic/center |
| Location | 420 S Peterson Ave, Blair, Wisconsin |
| Authorized Official Name and Position | Kari B Adank (CCO) |
| Authorized Official Contact | 6087758025 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gl Blair Clinic 1836 South Ave La Crosse WI 54601-5429 Ph: (608) 782-7300 | Gl Blair Clinic 420 S Peterson Ave Blair WI 54616-8861 Ph: (608) 782-7300 |
| NPI Number | 1336190941 |
|---|---|
| Provider Enumeration Date | 05/16/2006 |
| Last Update Date | 03/07/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336190941 | NPI | - | NPPES |
| 43062600 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (Wisconsin) | Primary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Secondary |
Tri-county Memorial Hospital, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 420 S Peterson Ave, Blair, WI 54616 Phone: 608-989-2505 Fax: 608-989-9844 |