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26425 Lakeland Avenue South Webster WI 54893-8341 | |
| (715) 866-4271 | |
| (715) 866-4284 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 26425 Lakeland Avenue South, Webster, Wisconsin |
| Authorized Official Name and Position | Mike Youso (CFO) |
| Authorized Official Contact | 7154830535 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
235 E State St Saint Croix Falls WI 54024-4117 Ph: (715) 483-3221 | 26425 Lakeland Avenue South Webster WI 54893-8341 Ph: (715) 866-4271 |
| NPI Number | 1851652374 |
|---|---|
| Provider Enumeration Date | 05/31/2012 |
| Last Update Date | 01/25/2023 |
| Medicare PECOS PAC ID | 9335032184 |
|---|---|
| Medicare Enrollment ID | O20120622000560 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851652374 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 1041 (Wisconsin) | Primary |
Ingalls Family Medicine Clinic Sc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7456 Main St W, Webster, WI 54893 Phone: 715-866-4271 Fax: 715-866-4284 | |