Organization
INTERNAL MEDICINE & PEDIATRICS, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. THERESANNE JOHNSON (OFFICE MANAGER)
(920) 563-7711
Entity
Organization
Contact information
Practice address
500 MCMILLEN ST, FORT ATKINSON, WI 53538-1233
(920) 563-7711
(920) 563-7705
Mailing address
500 MCMILLEN ST, FORT ATKINSON, WI 53538-1233
(920) 563-7711
(920) 563-7705
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
02/21/2006
Last updated
09/11/2025
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