| Plymouth Family Physicians, S.c. | |
|
1000 Eastern Ave Plymouth WI 53073-1921 | |
| (920) 893-0526 | |
| (920) 893-8068 |
| Full Name | Plymouth Family Physicians, S.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 1000 Eastern Ave, Plymouth, Wisconsin |
| Authorized Official Name and Position | Judy Klein (OFFICE MANAGER) |
| Authorized Official Contact | 9208930526 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Plymouth Family Physicians, S.c. 1000 Eastern Ave Plymouth WI 53073-1921 Ph: (920) 893-0526 | Plymouth Family Physicians, S.c. 1000 Eastern Ave Plymouth WI 53073-1921 Ph: (920) 893-0526 |
| NPI Number | 1548372964 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 3072796085 |
|---|---|
| Medicare Enrollment ID | O20110329000917 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548372964 | NPI | - | NPPES |
| 32707400 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 597162 (Wisconsin) | Primary |
| Provider Name | George S Schroeder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518953249 PECOS PAC ID: 3476554544 Enrollment ID: I20070117000139 |
| Provider Name | Mary Elizabeth Arenberg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740277086 PECOS PAC ID: 3375731698 Enrollment ID: I20101230000281 |
| Provider Name | Barbara J Lukas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356693071 PECOS PAC ID: 1759529555 Enrollment ID: I20130606000739 |
| Provider Name | Courtney A Hansen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871141051 PECOS PAC ID: 2466783527 Enrollment ID: I20191004000385 |