Organization
PRAIRIE MEDICINE LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BRENDA J JONES (OFFICE MANAGER)
(608) 326-6402
Entity
Organization
Contact information
Practice address
421 S BEAUMONT RD, PRAIRIE DU CHIEN, WI 53821-1905
(608) 326-6402
(608) 326-6404
Mailing address
421 S BEAUMONT RD, PRAIRIE DU CHIEN, WI 53821-1905
(608) 326-6402
(608) 326-6404
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0944967
—
IA
05
—
30071400
—
WI
Enumeration date
12/23/2005
Last updated
10/16/2007
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