THE DOC AT YOUR DOORLLC NPI 1104138882

NPI Information

NPI: 1104138882
Provider Name: THE DOC AT YOUR DOOR,LLC
Classification: Clinic/Center - 261QE0002X
Entity Type: Organization

Specialization: Emergency Care

Address:
N9554 HIGHLINE RD
KAUKAUNA, WI
ZIP 54130
Phone: (920) 277-9716
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THE DOC AT YOUR DOOR,LLC is an emergency care clinic center in Kaukauna, WI. THE DOC AT YOUR DOOR,LLC NPI is 1104138882. The provider is registered as an organization entity type.

The provider's business location address is:

N9554 HIGHLINE RD
KAUKAUNA, WI
ZIP 54130-502
Phone: (920) 277-9716
Fax: (920) 766-6802

The provider's authorized official is Patricia M Demery .
The authorized official title is President and has the following contact phone number (920) 277-9716.

The enumeration date for this NPI number is 7/9/2010 and was last updated on 11/29/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QE0002X	Clinic/Center	Emergency Care	32560	WISCONSIN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	WI1790	OTHER	WISCONSIN	MEDICARE PTAN
2	WI1789	OTHER	WISCONSIN	MEDICARE PTAN
3	31750000	MEDICAID	WISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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