Organization
COMMUNITY PEDIATRICS SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DOROTHY JEAN LARSON (ACCOUNT MANAGER)
(920) 885-3305
Entity
Organization
Contact information
Practice address
109 WARREN ST STE 4, BEAVER DAM, WI 53916-3082
(920) 885-3305
(920) 885-5506
Mailing address
109 WARREN ST STE 4, BEAVER DAM, WI 53916-3082
(920) 885-3305
(920) 885-5506
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34638800
—
WI
Enumeration date
05/15/2007
Last updated
04/08/2010
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us