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Organization
INGALLS FAMILY MEDICINE CLINIC SC
Active
Organization
INGALLS FAMILY MEDICINE CLINIC SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN W INGALLS MD (OWNER)
(715) 866-4271
Entity
Organization
Contact information
Practice address
7456 MAIN ST W, WEBSTER, WI 54893-8205
(715) 866-4271
(715) 866-4284
Mailing address
7456 MAIN ST W, WEBSTER, WI 54893-8205
(715) 866-4271
(715) 866-4284
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
31328
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21250000
—
WI
Enumeration date
01/11/2007
Last updated
08/22/2020
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