# BEAVER DAM COMMUNITY HOSPITALS INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MARSHFIELD CLINIC HEALTH SYSTEM INC
- **Other names:** (Inactive) Marshfield Medical Center - Beaver Dam Wound Clinic
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1992212062
- **Legal business name:** MARSHFIELD CLINIC HEALTH SYSTEM INC
- **Authorized official:** GORDON T EDWARDS (CFO/COO/AO)
- **Authorized official phone:** (715) 387-5823

## Contact information

- **Practice address:** 707 S UNIVERSITY AVE, BEAVER DAM, WI 53916-3027
- **Practice address phone:** (920) 887-7181
- **Mailing address:** 1000 N OAK AVE, ATTN: PROVIDER ENROLLMENT SERVICES/WWP, MARSHFIELD, WI 54449-5703
- **Mailing address phone:** (715) 389-0660

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 851-800 | WI | Yes |

## Other

- **Enumeration date:** 01/10/2018
- **Last updated:** 03/07/2022