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NPI 1992023295

NPI 1992023295 : MARSHFIELD CLINIC INC : MARSHFIELD, WI

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General NPI Number Information
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    NPI Number           |    1992023295
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    Entity Type          |    Organization 
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    Legal Business Name  |    MARSHFIELD CLINIC INC 
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Dates
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    Enumeration Date     |    05/11/2010
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    Last Update Date     |    04/24/2018
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Provider Practice Location Address
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    Address Line         |    630 S. CENTRAL AVE. SUITE 106
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    City                 |    MARSHFIELD
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    State                |    WI
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    Zip                  |    54449-4196
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    Country              |    US
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    Telephone            |    715-389-5900
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1000 N OAK AVE 
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    City                 |    MARSHFIELD
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    State                |    WI
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    Zip                  |    54449-5703
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    Country              |    US
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    Telephone            |    715-387-5511
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    Fax                  |    
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Authorized Official
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    Title or Position    |    MEDICAL DIRECTOR REIMBURSEMENT
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    Name                 |     MATTHEW  THOMAS 
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    Credential           |    MD
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    Telephone            |    715-387-5511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    332B00000X
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    Taxonomy Name        |    Durable Medical Equipment & Medical Supplies
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    License Number       |    
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    License Number State |    
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