Organization
ASCENSION MEDICAL GROUP-FOX VALLEY WISCONSIN, INC
Active
Other names
Ascension Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
J. BRYAN FISSEL (VP-FINANCE)
(414) 465-3000
Entity
Organization
Contact information
Practice address
1160 SERVICE RD, KIEL, WI 53042
(920) 894-3322
Mailing address
1160 SERVICE RD, KIEL, WI 53042-1281
(920) 738-2000
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32752000
—
WI
Enumeration date
05/23/2008
Last updated
03/27/2023
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