Hometown Physician Services Md, S.c. | |
401 Finvold St Woodville WI 54028 | |
(617) 304-2262 | |
Not Available |
Full Name | Hometown Physician Services Md, S.c. |
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Speciality | Family Medicine |
Location | 401 Finvold St, Woodville, Wisconsin |
Authorized Official Name and Position | Jeffrey Hendricks (MSO ADMINISTRATOR) |
Authorized Official Contact | 6173042262 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Hometown Physician Services Md, S.c. 401 Finvold St Woodville WI 54028-9719 Ph: () - | Hometown Physician Services Md, S.c. 401 Finvold St Woodville WI 54028 Ph: (617) 304-2262 |
NPI Number | 1558832055 |
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Provider Enumeration Date | 12/09/2018 |
Last Update Date | 12/16/2019 |
Medicare PECOS PAC ID | 3577802859 |
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Medicare Enrollment ID | O20190304002167 |
Identifier | Type | State | Issuer |
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1558832055 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Kristin A Severson-solberg |
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Provider Type | Practitioner - Geriatric Medicine |
Provider Identifiers | NPI Number: 1245201532 PECOS PAC ID: 7416096268 Enrollment ID: I20100123000200 |
Provider Name | Lisa R Shields |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1265699698 PECOS PAC ID: 0840238812 Enrollment ID: I20130507000112 |
Provider Name | Richard W Rapp |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1508121583 PECOS PAC ID: 3870888662 Enrollment ID: I20160817003111 |
Provider Name | Makenna R Pechumer |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1740807809 PECOS PAC ID: 7012333453 Enrollment ID: I20201102001901 |
Provider Name | Genna B Alden |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1689180283 PECOS PAC ID: 5991065153 Enrollment ID: I20230120000274 |
Provider Name | Jackie Jackie Yang |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1235506247 PECOS PAC ID: 4789016577 Enrollment ID: I20230505000889 |
Provider Name | Sara Persinger |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1669028833 PECOS PAC ID: 9739518010 Enrollment ID: I20230720002891 |