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Physicians Family Medicine

Provider NPI: 1073703153

Provider Information:
Gender: M
Not Sole Proprietor

Practice Location:
1531 S MADISON ST  APPLETON, WI 54915-1800 US
Tel: 920-996-3700  Fax: --

Business Mailing Address:
1531 S MADISON ST  APPLETON, WI 54915-1800 US
Tel: 920-996-3700  Fax: --

NPI Information:
NPI: 1073703153
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Family Medicine
Family Medicine
Organized Health Care Education/Training Program

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 207QS0010X





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