MEDICARE: MARSHFIELD CLINIC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1720164676
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARSHFIELD CLINIC

Provider Business Mailing Address
First Line	:	1000 N OAK AVE
Second Line	:
City	:	MARSHFIELD
State	:	WI
Zip	:	54449-5703
Country	:	US
Telephone Number	:	715-387-5511
Fax Number	:

Provider Business Practice Location Address
First Line	:	141 N. MAIN ST.
Second Line	:
City	:	LOYAL
State	:	WI
Zip	:	54446
Country	:	US
Telephone Number	:	715-255-8595
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTOR REIMBURSEMENT
Name	:	DAVID J SIMENSTAD
Credential	:	MD
Telephone Number	:	715-387-5511

Provider Enumeration Date	:	10/31/2006
Last Update Date	:	02/13/2008

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Directions to “MARSHFIELD CLINIC ” Practice Location

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