| Shell Lake Clinic, Ltd | |
|
105 4th Ave Shell Lake WI 54871-4457 | |
| (715) 468-2711 | |
| (715) 468-2727 |
| Full Name | Shell Lake Clinic, Ltd |
|---|---|
| Speciality | Family Medicine |
| Location | 105 4th Ave, Shell Lake, Wisconsin |
| Authorized Official Name and Position | Jeffrey L. Dunham (PRESIDENT) |
| Authorized Official Contact | 7154682711 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shell Lake Clinic, Ltd 105 4th Ave Shell Lake WI 54871-4457 Ph: (715) 468-2711 | Shell Lake Clinic, Ltd 105 4th Ave Shell Lake WI 54871-4457 Ph: (715) 468-2711 |
| NPI Number | 1508225988 |
|---|---|
| Provider Enumeration Date | 02/15/2016 |
| Last Update Date | 02/15/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508225988 | NPI | - | NPPES |
| 1932141157 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 61281-20 (Wisconsin) | Primary |
Shell Lake Clinic, Ltd Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 105 4th Ave, Shell Lake, WI 54871 Phone: 715-468-2711 Fax: 715-468-2727 | |
Stone Lake Rural Health Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 113 4th Avenue, Shell Lake, WI 54871 Phone: 715-468-7833 | |
Indianhead Medical Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 113 4th Ave, Shell Lake, WI 54871 Phone: 715-468-7833 Fax: 715-468-7303 |