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General NPI Number Information
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NPI Number | 1942025572
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Entity Type | Organization
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Legal Business Name | OAK LEAF SURGERY CENTER LLC
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Dates
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Enumeration Date | 11/19/2024
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Last Update Date | 01/27/2026
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Provider Practice Location Address
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Address Line | 3119 WOODMAN DR
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City | ALTOONA
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State | WI
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Zip | 54720-2668
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Country | US
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Telephone | 715-858-3700
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Fax | 715-594-9490
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Provider Business Mailing Address
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Address Line | 3119 WOODMAN DR
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City | ALTOONA
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State | WI
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Zip | 54720-2668
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Country | US
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Telephone | 715-858-3700
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Fax | 715-594-9490
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Authorized Official
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Title or Position | OFFICER AND AUTHORIZED OFFICIAL
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Name | JENNIFER BALDOCK
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Credential |
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Telephone | 615-234-5954
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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