GUNDERSEN CLINIC LTD. NPI 1780636480

NPI Information

GUNDERSEN CLINIC, LTD. is a clinic center in Independence, WI. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). GUNDERSEN CLINIC, LTD. NPI is 1780636480. The provider is registered as an organization entity type.
The provider Other Name Is Gl Independence Clinic.

The provider's business location address is:

35791 OSSEO RD
INDEPENDENCE, WI
ZIP 54747-096
Phone: (608) 782-7300

The provider's authorized official is Kari B Adank .
The authorized official title is Cco and has the following contact phone number (608) 775-8025.

The CLIA number assigned to this NPI record is 52D0396816 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/17/2006 and was last updated on 3/7/2016.

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:

Other Identifiers

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

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