CREEKSIDE FAMILY MEDICINE LLC NPI 1558610063

NPI Information

NPI: 1558610063
Provider Name: CREEKSIDE FAMILY MEDICINE, LLC
Classification: Clinic/Center - 261QH0100X
Entity Type: Organization

Specialization: Health Service

Address:
3608 N BRACKEN DR
APPLETON, WI
ZIP 54911
Phone: (330) 466-4431
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CREEKSIDE FAMILY MEDICINE, LLC is a health service clinic center in Appleton, WI. CREEKSIDE FAMILY MEDICINE, LLC NPI is 1558610063. The provider is registered as an organization entity type.

The provider's business location address is:

3608 N BRACKEN DR
APPLETON, WI
ZIP 54911-504
Phone: (330) 466-4431

The provider's authorized official is Samuel J Heiks .
The authorized official title is Sole Member and has the following contact phone number (330) 466-4431.

The enumeration date for this NPI number is 8/30/2012 and was last updated on 10/21/2014.

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	261QH0100X	Clinic/Center	Health Service	35097870	OHIO	Yes

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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