FAMILY MEDICINE & SURGERY LLC NPI 1922305077

NPI Information

NPI: 1922305077
Provider Name: FAMILY MEDICINE & SURGERY LLC
Classification: General Practice - 208D00000X
Entity Type: Organization
Address:
3066 MAIN ST
EAST TROY, WI
ZIP 53120
Phone: (262) 642-7313
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FAMILY MEDICINE & SURGERY LLC is a general practice in East Troy, WI. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee FAMILY MEDICINE & SURGERY LLC NPI is 1922305077. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3066 MAIN ST
EAST TROY, WI
ZIP 53120-148
Phone: (262) 642-7313
Fax: (262) 642-4251

The provider's authorized official is Neil James Rennick .
The authorized official title is Sole Proprietor and has the following contact phone number (262) 642-7313.

The enumeration date for this NPI number is 2/24/2011 and was last updated on 2/24/2011.

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	208D00000X	General Practice		26462	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	26462	OTHER	WISCONSIN	STATE OF WISCONSIN LICENSE
2	80591	OTHER	WISCONSIN	MEDICARE ID
3	B56004	MEDICARE UPIN	WISCONSIN
4	1508062043	OTHER	WISCONSIN	TYPE 1 NPI
5	30100300	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: 4/28/2024

NPI Synchronization or Removal

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