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General NPI Number Information
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NPI Number | 1013098458
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Entity Type | Organization
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Legal Business Name | ROGERS AND NELSON SURGICAL ASSOCIATES, S.C.
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 701 GROVE STR
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City | WILD ROSE
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State | WI
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Zip | 54984
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Country | US
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Telephone | 920-361-5340
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Fax | 920-361-5335
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Provider Business Mailing Address
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Address Line | 225 MEMORIAL DR SUITE 2000
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City | BERLIN
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State | WI
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Zip | 54923-1243
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Country | US
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Telephone | 902-361-5340
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Fax | 920-361-5335
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Authorized Official
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Title or Position | BILLING CLERK
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Name | TAMMY J CHIER
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Credential | RHIT
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Telephone | 920-361-5765
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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