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Organization

THEDACARE, INCORPORATED

Active
Other names
ThedaCare Physicians
Organization subpart
No

Provider details

NPI number
Authorized official
WILLIAM FLETT (CFO)
(920) 454-4013
Entity
Organization

Contact information

Practice address
1405 MILL ST, NEW LONDON, WI 54961-2155
(920) 830-5900
(920) 830-5910
Mailing address
3 NEENAH CTR, NEENAH, WI 54956-3070
(920) 454-4229
(920) 993-5001

Taxonomy

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

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
32883500
WI
01
WI2721
MEDICARE PTAN
WI
Enumeration date
08/16/2006
Last updated
01/02/2024
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