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General NPI Number Information
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NPI Number | 1104996081
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Entity Type | Organization
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Legal Business Name | SPRING MEDICAL ASSOCIATES,LLC
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 156 WEST JEFFERSON STREET
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City | SPRING GREEN
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State | WI
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Zip | 53588
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Country | US
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Telephone | 608-588-2600
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Fax | 608-588-2644
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Provider Business Mailing Address
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Address Line | 156 WEST JEFFERSON STREET P O BOX 250
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City | SPRING GREEN
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State | WI
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Zip | 53588
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Country | US
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Telephone | 608-588-2600
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Fax | 608-588-2644
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Authorized Official
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Title or Position | FAMILY PRACTICE
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Name | DR. HISHAM A OSMAN
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Credential | M.D.
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Telephone | 608-588-2600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 37632
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License Number State | WI
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