# ASCENSION MEDICAL GROUP-FOX VALLEY WISCONSIN, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Ascension Medical Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093982530
- **Authorized official:** DAVID JIROVEC (SR FINANCE DIRECTOR - MEDICAL GROUP)
- **Authorized official phone:** (715) 347-6655

## Contact information

- **Practice address:** 1420 ALGOMA ST, NEW LONDON, WI 54961
- **Practice address phone:** (920) 982-8300
- **Mailing address:** 1420 ALGOMA ST, NEW LONDON, WI 54961-2104
- **Mailing address phone:** (920) 738-2000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/14/2008
- **Last updated:** 05/19/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 32752000 | — | WI |