Healthcare Provider Details
I. General information
NPI: 1194125534
Provider Name (Legal Business Name): NEW WOMENS CARE S C
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/03/2014
Last Update Date: 09/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
855 SOUTH MAIN ST.
OCONTO FALLS WI
54154
US
IV. Provider business mailing address
500 W BAY SHORE ST
MARINETTE WI
54143-4207
US
V. Phone/Fax
- Phone: 920-846-9995
- Fax:
- Phone: 715-732-4005
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | 29332-20 |
| License Number State | WI |
VIII. Authorized Official
Name: DR.
JAMES
MICHAEL
ARNOLD
Title or Position: PRESIDENT
Credential: M.D.
Phone: 715-723-4005