Organization
FOND DU LAC SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN N LITTLE (SVP & CFO)
(920) 926-5402
Entity
Organization
Contact information
Practice address
421 CAMELOT DRIVE, FOND DU LAC, WI 54935
(920) 926-5407
Mailing address
430 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 926-4472
(920) 926-8885
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
05/04/2006
Last updated
08/29/2007
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