Lodi Medical Clinic | |
160 Valley Dr Lodi WI 53555-1464 | |
(608) 592-3296 | |
Not Available |
Full Name | Lodi Medical Clinic |
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Speciality | Family Medicine |
Location | 160 Valley Dr, Lodi, Wisconsin |
Authorized Official Name and Position | James Dregney (CFO) |
Authorized Official Contact | 6086437212 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Lodi Medical Clinic 160 Valley Dr Lodi WI 53555-1464 Ph: () - | Lodi Medical Clinic 160 Valley Dr Lodi WI 53555-1464 Ph: (608) 592-3296 |
NPI Number | 1225003445 |
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Provider Enumeration Date | 02/21/2006 |
Last Update Date | 02/05/2019 |
Medicare PECOS PAC ID | 8224948054 |
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Medicare Enrollment ID | O20120928000145 |
Identifier | Type | State | Issuer |
---|---|---|---|
1225003445 | NPI | - | NPPES |
CI6108 | Other | RAILROAD MEDICARE | |
32764200 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Secondary |