East Side Family Practice Sc in Green Bay - General Practice
East Side Family Practice Sc - NPI 1861527863
East Side Family Practice Sc is a General Practice in Green Bay, Wisconsin. East Side Family Practice Sc practices all healthcare services and medical treatments related to General Practice. The NPI Number for East Side Family Practice Sc is 1861527863. The last update date is 2010-10-25.
East Side Family Practice Sc's current location address is 424 S Monroe Ave Ste 106, Green Bay, Wisconsin. You can contact this provider via phone number 9204374366 and fax number 9204370954. The mailing address for East Side Family Practice Sc is 424 S Monroe Ave Ste 106, Green Bay, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | East Side Family Practice Sc |
|---|---|
| Address | 424 S Monroe Ave Ste 106, Green Bay, Wisconsin |
| Phone Number | 9204374366 |
| Fax Number | 9204370954 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Dobson Robert Joseph |
| Credentials | D.O. |
| Telephone Number | 9204374366 |
NPI Number Detail
| NPI Number | 1861527863 |
|---|---|
| Provider Enumeration Date | 2007-02-22 |
| Last Updated Date | 2010-10-25 |
Provider Mailing Address Detail
| Address | 424 S Monroe Ave Ste 106 |
|---|---|
| City | Green Bay |
| State | Wisconsin (WI) |
| Post Code | 543014054 |
| Phone Number | 9204374366 |
| Fax Number | 9204370954 |
Provider's Primary Taxonomy Detail
| Speciality | General Practice |
|---|---|
| Taxonomy | 208D00000X |
| Licence No | 26550 |
|
Definition: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 80085001 | RR MEDICARE PROV # | ||
| 30021900 | WI | -- |
Post Comment/ Review Below
What is the unique identification code assigned to East Side Family Practice Sc by the Centers for Medicare & Medicaid Services?
The East Side Family Practice Sc has been issued the NPI (National Provider Identifier) 1861527863. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Where is the East Side Family Practice Sc located?
The East Side Family Practice Sc is located at 424 S Monroe Ave Ste 106, Green Bay, WI 543014054.
What is the East Side Family Practice Sc's area of specialization and corresponding taxonomy classification?
The East Side Family Practice Sc's specialty field is General Practice, and it falls under the taxonomy code 208D00000X, which categorizes healthcare providers based on their specialties.
When did East Side Family Practice Sc receive its 1861527863 assignment?
The East Side Family Practice Sc was assigned its 1861527863 on 2007-02-22, which is the date when this unique identifier was issued to the organization.
As of what date was the information pertaining to East Side Family Practice Sc, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to East Side Family Practice Sc, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2010-10-25.