Organization
FOX VALLEY HEMATOLOGY & ONCOLOGY, S.C.
Active
Parent organization
FOX VALLEY HEMATOLOGY & ONCOLOGY, S. C.
Organization subpart
Yes
Provider details
NPI number
Legal business name
FOX VALLEY HEMATOLOGY & ONCOLOGY, S. C.
Authorized official
TIMOTHY F GOGGINS M.D. (CHIEF MEDICAL OFFICER/PHYSICIAN)
(920) 749-1171
Entity
Organization
Contact information
Practice address
3925 N GATEWAY DR, APPLETON, WI 54913-7863
(920) 749-1171
(920) 831-1472
Mailing address
3232 N BALLARD RD, SUITE 200, APPLETON, WI 54911-8804
(920) 749-9668
(920) 734-5307
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
—
—
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32802700
—
WI
Enumeration date
04/09/2007
Last updated
01/10/2017
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