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Organization

MARK A MIDTHUN MD LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MARK A. MIDTHUN MD (PSYCHIATRIST)
(608) 397-5904
Entity
Organization

Contact information

Practice address
3626 EAST AVE S STE 2A, LA CROSSE, WI 54601-7221
(608) 778-1114
(608) 778-1147
Mailing address
W6602 SCHILLING RD UNIT C, ONALASKA, WI 54650-9343
(608) 397-5904

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary

Other

Enumeration date
09/13/2019
Last updated
03/30/2020
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