Organization
APPLETON INTENSIVIST GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISHA C FALK (VP OF CONTRACTING)
(337) 609-1221
Entity
Organization
Contact information
Practice address
1500 SW 1ST AVE, OCALA, FL 34471-6504
(352) 351-7200
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363LC0200X
Critical Care Medicine Nurse Practitioner
—
—
Other
Enumeration date
05/02/2019
Last updated
03/23/2022
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