Organization
SAUK PRAIRIE HEALTHCARE INC
Active
Other names
Lodi Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES DREGNEY (CFO)
(608) 643-7212
Entity
Organization
Contact information
Practice address
160 VALLEY DR, LODI, WI 53555-1464
(608) 592-3296
Mailing address
160 VALLEY DR, LODI, WI 53555-1464
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32764200
—
WI
01
—
CI6108
RAILROAD MEDICARE
—
Enumeration date
02/21/2006
Last updated
09/17/2025
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