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AGNESIAN HEALTHCARE INC

Physicians Physical Medicine & Rehabilitation

Provider NPI: 1730162991

Organization Information:
Organization Name:  AGNESIAN HEALTHCARE INC
Organization is not Subpart
Authorized Official:  KATHERINE  VERGOS  PRESIDENT  920-926-4979

Practice Location:
420 E DIVISION ST  FOND DU LAC, WI 54935-4560 US
Tel: 920-923-7400  Fax: --

Business Mailing Address:
420 E DIVISION ST  FOND DU LAC, WI 54935-4560 US
Tel: 920-923-8340  Fax: --

NPI Information:
NPI: 1730162991
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N208100000XPhysicians
Physical Medicine & Rehabilitation
N208600000XPhysicians
Surgery
N208800000XPhysicians
Urology
N213E00000XPodiatric Medicine & Surgery Service Providers
Podiatrist
N332B00000XSuppliers
Durable Medical Equipment & Medical Supplies
N207V00000XPhysicians
Obstetrics & Gynecology
N207W00000XPhysicians
Ophthalmology
N207X00000XPhysicians
Orthopaedic Surgery
N207Y00000XPhysicians
Otolaryngology
N208000000XPhysicians
Pediatrics
N152W00000XEye and Vision Services Providers
Optometrist
N207L00000XPhysicians
Anesthesiology
N207N00000XPhysicians
Dermatology
N207R00000XPhysicians
Internal Medicine
Y207Q00000XPhysicians
Family Medicine

Other Provider Identifiers:

IssuerNumberStateType
38437100WI05
RAILROAD MEDICARE GRP #CY0124WI01
32841900WI05



American Medical Association 2012 taxonomy code information

Code: 207Q00000X

Type:

Classification:



Definition:



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