West Bend Clinic, Inc. in West Bend - Diagnostic Radiology
West Bend Clinic, Inc. - NPI 1235106311
West Bend Clinic, Inc. is a Diagnostic Radiology in West Bend, Wisconsin. West Bend Clinic, Inc. practices all healthcare services and medical treatments related to Diagnostic Radiology. The NPI Number for West Bend Clinic, Inc. is 1235106311. The last update date is 2011-05-04.
West Bend Clinic, Inc.'s current location address is 1700 W Paradise Dr, West Bend, Wisconsin. You can contact this provider via phone number 2623343451. The mailing address for West Bend Clinic, Inc. is 1700 W Paradise Dr, West Bend, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | West Bend Clinic, Inc. |
|---|---|
| Address | 1700 W Paradise Dr, West Bend, Wisconsin |
| Phone Number | 2623343451 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | MEDICAL DI |
|---|---|
| Authorized Official Name | Blommel G Gregory |
| Credentials | MD |
| Telephone Number | 2623066336 |
NPI Number Detail
| NPI Number | 1235106311 |
|---|---|
| Provider Enumeration Date | 2006-03-07 |
| Last Updated Date | 2011-05-04 |
Provider Mailing Address Detail
| Address | 1700 W Paradise Dr |
|---|---|
| City | West Bend |
| State | Wisconsin (WI) |
| Post Code | 530959795 |
| Phone Number | 2623343451 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Diagnostic Radiology |
|---|---|
| Taxonomy | 2085R0202X |
|
Definition: A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 21251400 | WI | -- |
Post Comment/ Review Below
Could you please share the complete physical location address where West Bend Clinic, Inc.'s facilities are situated?
The facilities of West Bend Clinic, Inc. are physically located at the following address: 1700 W Paradise Dr, West Bend, WI, 530959795.
What is West Bend Clinic, Inc.'s specialized field of practice, and what is the corresponding taxonomy classification code?
The West Bend Clinic, Inc.'s area of specialization is Diagnostic Radiology, and the corresponding taxonomy code that categorizes this field of practice is 2085R0202X.
On what date was the 1235106311 assigned to West Bend Clinic, Inc.?
The West Bend Clinic, Inc. was issued its 1235106311 on 2006-03-07, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
On what date did the West Bend Clinic, Inc. receive the assignment of its 1235106311 from the Centers for Medicare & Medicaid Services?
The West Bend Clinic, Inc. was issued its 1235106311 by the Centers for Medicare & Medicaid Services on 2006-03-07.
When was the information regarding West Bend Clinic, Inc. most recently updated?
The details pertaining to the West Bend Clinic, Inc., including its address, specialty, and other relevant information, were last refreshed on 2011-05-04.