Green Lake Medical Clinic , S.C. in Green Lake - Family Medicine
Green Lake Medical Clinic , S.C. - NPI 1306986716
Green Lake Medical Clinic , S.C. is a Family Medicine in Green Lake, Wisconsin. Green Lake Medical Clinic , S.C. practices all healthcare services and medical treatments related to Family Medicine. The NPI Number for Green Lake Medical Clinic , S.C. is 1306986716. The last update date is 2020-08-22.
Green Lake Medical Clinic , S.C.'s current location address is N6205 Busse Drive, Green Lake, Wisconsin. You can contact this provider via phone number 9202943444 and fax number 9202946660. The mailing address for Green Lake Medical Clinic , S.C. is N6205 Busse Drive, Green Lake, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Green Lake Medical Clinic , S.C. |
|---|---|
| Address | N6205 Busse Drive, Green Lake, Wisconsin |
| Phone Number | 9202943444 |
| Fax Number | 9202946660 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Willett Rice Thomas |
| Credentials | D.O. |
| Telephone Number | 9202943444 |
NPI Number Detail
| NPI Number | 1306986716 |
|---|---|
| Provider Enumeration Date | 2007-02-07 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | N6205 Busse Drive |
|---|---|
| City | Green Lake |
| State | Wisconsin (WI) |
| Post Code | 54941 |
| Phone Number | 9202943444 |
| Fax Number | 9202946660 |
Provider's Primary Taxonomy Detail
| Speciality | Family Medicine |
|---|---|
| Taxonomy | 207Q00000X |
| Licence No | 17659 |
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Definition: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine i |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 30071600 | WI | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Green Lake Medical Clinic , S.C. by the Centers for Medicare & Medicaid Services (CMS)?
The Green Lake Medical Clinic , S.C. has been assigned the NPI (National Provider Identifier) 1306986716. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you share the physical location details of Green Lake Medical Clinic , S.C.?
The Green Lake Medical Clinic , S.C. is situated at N6205 Busse Drive, in the city of Green Lake, state of WI, with the zip code 54941.
What is Green Lake Medical Clinic , S.C.'s area of expertise and its corresponding taxonomy classification?
The Green Lake Medical Clinic , S.C.'s field of specialization is Family Medicine, and it falls under the taxonomy code 207Q00000X, which categorizes healthcare providers based on their areas of practice.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1306986716 to Green Lake Medical Clinic , S.C.?
The Centers for Medicare & Medicaid Services originally issued the 1306986716 to Green Lake Medical Clinic , S.C. on 2007-02-07.
As of what date were the Green Lake Medical Clinic , S.C.'s details last updated?
The information pertaining to the Green Lake Medical Clinic , S.C., including its address, specialty, and other details, was most recently updated on 2020-08-22.
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