Organization
PARK HILL CLINIC, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARLYS SCHMIDT (CCO)
(920) 478-3776
Entity
Organization
Contact information
Practice address
111 ANNA ST, WATERLOO, WI 53594-1184
(920) 478-3776
(920) 478-3979
Mailing address
111 ANNA ST, WATERLOO, WI 53594-1184
(920) 478-3776
(920) 478-3979
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P37
DEAN HEALTH CARE PCP #
WI
Enumeration date
07/16/2006
Last updated
08/22/2020
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