Healthcare Provider Details

I. General information

NPI: 1497834550
Provider Name (Legal Business Name): MINERAL POINT MEDICAL CENTER SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 04/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1204 JOSEPH ST
DODGEVILLE WI
53533-9670
US

IV. Provider business mailing address

104 HIGH ST
MINERAL POINT WI
53565-1289
US

V. Phone/Fax

Practice location:
  • Phone: 608-935-2308
  • Fax: 608-935-2644
Mailing address:
  • Phone: 608-987-2346
  • Fax: 608-987-2490

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. CHRIS SLANEY
Title or Position: CREDENTIALING DEPT
Credential:
Phone: 608-987-2346