Organization
APPLETON CARDIOLOGY ASSOCIATES SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LARRY SOBAL (CEO)
(920) 731-8900
Entity
Organization
Contact information
Practice address
1818 N MEADE ST, APPLETON, WI 54911-3454
(920) 731-8900
(920) 225-1479
Mailing address
1818 N MEADE ST, APPLETON, WI 54911-3454
(920) 731-8900
(920) 225-1479
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
—
163W00000X
Registered Nurse
—
—
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207RC0001X
Clinical Cardiac Electrophysiology Physician
—
—
207RI0011X
Interventional Cardiology Physician
—
—
207UN0901X
Nuclear Cardiology Physician
—
—
363AM0700X
Medical Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
364S00000X
Clinical Nurse Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32668700
—
WI
01
—
CO1870
RAILROAD MEDICARE NUMBER
WI
Enumeration date
05/10/2006
Last updated
04/20/2008
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