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Organization
APPLETON CARDIAC & THORACIC SURGERY, S.C.
Active
Organization
APPLETON CARDIAC & THORACIC SURGERY, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYNN KERKHOFF (MANAGER)
(920) 831-6135
Entity
Organization
Contact information
Practice address
1818 N MEADE ST, SUITE N347, APPLETON, WI 54911-3454
(920) 225-1449
(920) 225-1425
Mailing address
1818 N MEADE ST, SUITE N347, APPLETON, WI 54911-3454
(920) 225-1449
(920) 225-1425
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
44645
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34279900
—
WI
Enumeration date
10/31/2007
Last updated
11/07/2007
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