# NORTHERN WISCONSIN BONE & JOINT CENTER, LTD

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

## Provider details

- **NPI number:** 1548300460
- **Authorized official:** CARILYN OLEJNICZAK (BILLING ADMINISTRATOR)
- **Authorized official phone:** (715) 358-7965

## Contact information

- **Practice address:** 201 HOSPITAL RD, EAGLE RIVER, WI 54521-8835
- **Practice address phone:** (715) 358-1911
- **Practice address fax:** (715) 358-1912
- **Mailing address:** 7520 US HIGHWAY 51 S, MINOCQUA, WI 54548-9202
- **Mailing address phone:** (715) 358-1911
- **Mailing address fax:** (715) 358-1912

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/08/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1052540001 | DMERC | WI |
| 05 | — | 21298800 | — | WI |
| 01 | — | CQ2410 | RRMEDICARE | WI |