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Organization

INGALLS FAMILY MEDICINE CLINIC SC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOHN W INGALLS MD (OWNER)
(715) 866-4271
Entity
Organization

Contact information

Practice address
7456 MAIN ST W, WEBSTER, WI 54893-8205
(715) 866-4271
(715) 866-4284
Mailing address
7456 MAIN ST W, WEBSTER, WI 54893-8205
(715) 866-4271
(715) 866-4284

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
31328
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
21250000
WI
Enumeration date
01/11/2007
Last updated
08/22/2020
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