Healthcare Provider Details

I. General information

NPI: 1447319116
Provider Name (Legal Business Name): JEFFERSON COUNTY HEALTH DEPARMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 08/01/2025
Certification Date: 08/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1541 ANNEX RD
JEFFERSON WI
53549-9803
US

IV. Provider business mailing address

1541 ANNEX RD
JEFFERSON WI
53549-9803
US

V. Phone/Fax

Practice location:
  • Phone: 920-674-7275
  • Fax: 920-674-7477
Mailing address:
  • Phone: 920-674-7275
  • Fax: 920-674-7477

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH MCGEARY
Title or Position: DIRECTOR/HEALTH OFFICER
Credential:
Phone: 920-674-7275