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OBSTETRICS GYNECOLOGY CLINIC OF EAU CLAIRE S.C. NPI 1619037918


NPI Information

NPI: 1619037918
Provider Name: OBSTETRICS GYNECOLOGY CLINIC OF EAU CLAIRE, S.C.
Classification: Obstetrics & Gynecology - 207VG0400X
Entity Type: Organization

Specialization: Gynecology

Address:
1110 OAK RIDGE DR
EAU CLAIRE, WI
ZIP 54701
Phone: (715) 836-9020
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OBSTETRICS GYNECOLOGY CLINIC OF EAU CLAIRE, S.C. is a gynecology obstetrics gynecology in Eau Claire, WI. The provider is a physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions. Source: National Uniform Claim Committee OBSTETRICS GYNECOLOGY CLINIC OF EAU CLAIRE, S.C. NPI is 1619037918. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1110 OAK RIDGE DR
EAU CLAIRE, WI
ZIP 54701-133
Phone: (715) 836-9020
Fax: (715) 834-9833

The provider's authorized official is Irfane M. Khatib .
The authorized official title is President and has the following contact phone number (715) 836-9020.

The enumeration date for this NPI number is 12/10/2006 and was last updated on 8/22/2020.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207VG0400XObstetrics & GynecologyGynecologyWISCONSINYes
2207VX0000XObstetrics & GynecologyObstetricsWISCONSINX

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
131066700MEDICAIDWISCONSIN

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: 4/28/2024

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