Healthcare Provider Details

I. General information

NPI: 1043438492
Provider Name (Legal Business Name): MERCY MEDICAL CENTER OF OSHKOSH, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 W 9TH AVE
OSHKOSH WI
54904-7247
US

IV. Provider business mailing address

2700 W 9TH AVE
OSHKOSH WI
54904-7247
US

V. Phone/Fax

Practice location:
  • Phone: 920-236-1850
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0401X
TaxonomyComprehensive Outpatient Rehabilitation Facility (CORF)
License Number
License Number State

VIII. Authorized Official

Name: SUSAN DWYER
Title or Position: CFO
Credential:
Phone: 414-465-3093