Individual
JOYCE BAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
520 W 3RD ST, KIMBERLY, WI 54136-1300
(920) 788-7680
(920) 788-7688
Mailing address
PO BOX 8003, APPLETON, WI 54912-8003
(920) 996-3298
(920) 738-5787
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
26747
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005845003
MEDICARE PTAN
WI
05
—
30843500
—
WI
Enumeration date
08/03/2006
Last updated
11/16/2011
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