Organization
PLYMOUTH FAMILY PHYSICIANS, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUDY KLEIN (OFFICE MANAGER)
(920) 893-0526
Entity
Organization
Contact information
Practice address
1000 EASTERN AVE, PLYMOUTH, WI 53073-1921
(920) 893-0526
(920) 893-8068
Mailing address
1000 EASTERN AVE, PLYMOUTH, WI 53073-1921
(920) 893-0526
(920) 893-8068
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
597162
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32707400
—
WI
Enumeration date
08/31/2006
Last updated
08/22/2020
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