Organization
BELOIT COLLEGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUTH GRAY (ASSISTANT ADMINISTRATOR-OPERATIONS)
(608) 364-1348
Entity
Organization
Contact information
Practice address
700 COLLEGE ST, BELOIT, WI 53511-5509
(608) 364-1348
(608) 364-2236
Mailing address
1905 HUEBBE PKWY, BELOIT, WI 53511-1842
(608) 364-1348
(608) 364-2236
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
Other
Enumeration date
08/10/2007
Last updated
08/10/2007
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