Healthcare Provider Details

I. General information

NPI: 1275578064
Provider Name (Legal Business Name): AURORA MEDICAL CENTER OF OSHKOSH, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 10/01/2025
Certification Date: 10/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

855 N WESTHAVEN DR
OSHKOSH WI
54904
US

IV. Provider business mailing address

PO BOX 735041
CHICAGO IL
60673-5041
US

V. Phone/Fax

Practice location:
  • Phone: 920-456-6000
  • Fax:
Mailing address:
  • Phone: 920-456-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number
License Number State

VIII. Authorized Official

Name: KARA RICHARDSON
Title or Position: VP MANAGED HEALTH
Credential:
Phone: 704-631-0450