# FOND DU LAC PSYCHIATRY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144466608
- **Authorized official:** DR. JEFFREY THOMAS JUNIG MD PHD (OWNER)
- **Authorized official phone:** (920) 923-9054

## Contact information

- **Practice address:** 1020 S MAIN ST, SUITE A, FOND DU LAC, WI 54935-6102
- **Practice address phone:** (920) 923-9054
- **Practice address fax:** (920) 322-9193
- **Mailing address:** 1020 S MAIN ST, SUITE A, FOND DU LAC, WI 54935-6102
- **Mailing address phone:** (920) 923-9054
- **Mailing address fax:** (920) 322-9193

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 32668-020 | WI | Yes |

## Other

- **Enumeration date:** 01/05/2009
- **Last updated:** 01/05/2009