Healthcare Provider Details
I. General information
NPI: 1124984901
Provider Name (Legal Business Name): OREGON ASC COMPANY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/24/2025
Last Update Date: 12/24/2025
Certification Date: 12/23/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
250 WEST 6TH AVENUE SUITE 100
OSHKOSH WI
54902
US
IV. Provider business mailing address
250 WEST 6TH AVENUE SUITE 100
OSHKOSH WI
54902
US
V. Phone/Fax
- Phone: 920-651-8200
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA1903X |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
WILLIAM
FLETT
Title or Position: CFO
Credential:
Phone: 920-454-4013