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Organization
NORTHERN WISCONSIN BONE & JOINT CENTER
Active
Organization
NORTHERN WISCONSIN BONE & JOINT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN L TADYCH M.D. (PRESIDENT)
(715) 358-1911
Entity
Organization
Contact information
Practice address
7520 US HIGHWAY 51 S, STE A, MINOCQUA, WI 54548-8944
(715) 358-1911
(715) 358-6158
Mailing address
7520 US HIGHWAY 51 S, STE A, MINOCQUA, WI 54548-8944
(715) 358-1911
(715) 358-6158
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
NULL
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1052540001
DMERC NUMBER
WI
05
—
21298800
—
WI
Enumeration date
11/13/2006
Last updated
02/18/2013
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