Healthcare Provider Details

I. General information

NPI: 1265590848
Provider Name (Legal Business Name): FOX VALLEY PULMONARY MEDICINE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 E CAPITOL DR STE 2600
APPLETON WI
54911-8735
US

IV. Provider business mailing address

2500 E CAPITOL DR STE 2600
APPLETON WI
54911-8735
US

V. Phone/Fax

Practice location:
  • Phone: 920-734-9600
  • Fax: 920-734-4773
Mailing address:
  • Phone: 920-734-9600
  • Fax: 920-734-4773

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: TRACI SCHWALBACH
Title or Position: BILLING
Credential:
Phone: 920-358-1139