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Organization
WILD ROSE COMMUNITY MEMORIAL HOSPITAL INC DBA WAUSHARA FAMILY PHYSICIA
Active
Organization
WILD ROSE COMMUNITY MEMORIAL HOSPITAL INC DBA WAUSHARA FAMILY PHYSICIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD CAVES (PRESIDENT)
(920) 622-5576
Entity
Organization
Contact information
Practice address
601 GROVE AVENUE, WILD ROSE, WI 54984-0243
(920) 622-5560
Mailing address
701 GROVE AVE, WILD ROSE, WI 54984-0243
(920) 622-5560
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32829100
—
WI
Enumeration date
06/09/2006
Last updated
03/18/2013
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