=====================================================
General NPI Number Information
=====================================================
NPI Number | 1295689024
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ASTIA HEALTH CLINICAL SERVICES, SC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/26/2026
-----------------------------------------------------
Last Update Date | 02/26/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1670 SOUTH BLVD STE 101A
-----------------------------------------------------
City | BARABOO
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53913-2944
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 608-995-2847
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 66
-----------------------------------------------------
City | MARATHON
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 54448-0066
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 715-317-5846
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MEDICAL DIRECTOR
-----------------------------------------------------
Name | ALEXANDER L SOMMERS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 715-847-2304
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------