Organization
KAUKAUNA CLINIC, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL RUSSO MD (PRESIDENT)
(920) 766-4656
Entity
Organization
Contact information
Practice address
305 E 12TH ST, KAUKAUNA, WI 54130-2865
(920) 766-4656
(920) 766-4659
Mailing address
305 E 12TH ST, KAUKAUNA, WI 54130-2865
(920) 766-4656
(920) 766-4659
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32792500
—
WI
Enumeration date
04/21/2006
Last updated
11/13/2025
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