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NPI Code Detail

MEDICARE: MOSAIC FAMILY HEALTH, INC

MEDICARE: MOSAIC FAMILY HEALTH, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1548653389
Entity Type Code : Organization
Provider Name (Legal Business Name) : MOSAIC FAMILY HEALTH, INC
Provider Business Mailing Address
First Line : 229 S MORRISON ST
Second Line :
City : APPLETON
State : WI
Zip : 54911-5725
Country : US
Telephone Number : 920-832-2783
Fax Number :
Provider Business Practice Location Address
First Line : 100 N ONEIDA ST
Second Line :
City : APPLETON
State : WI
Zip : 54911-4733
Country : US
Telephone Number : 920-832-2783
Fax Number :
Authorized Official
Title or Position : CAMPUS DIRECTOR
Name : LEE VOGEL
Credential : MD
Telephone Number : 920-832-2783
Provider Enumeration Date : 03/17/2015
Last Update Date : 05/08/2026

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Directions to “MOSAIC FAMILY HEALTH, INC ” Practice Location

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