# THEDA CLARK OB HOSPITALISTS SC

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

## Provider details

- **NPI number:** 1295510196
- **Authorized official:** ERIC G EBERTS MD (PRESIDENT)
- **Authorized official phone:** (920) 729-7105

## Contact information

- **Practice address:** 130 2ND ST, NEENAH, WI 54956-2883
- **Practice address phone:** (920) 729-7105
- **Practice address fax:** (920) 831-8306
- **Mailing address:** 3232 N BALLARD RD STE 100, APPLETON, WI 54911-8804
- **Mailing address phone:** (920) 729-7105
- **Mailing address fax:** (920) 831-8306

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/29/2023
- **Last updated:** 08/29/2023