Organization
ASCENSION MEDICAL GROUP-FOX VALLEY WISCONSIN, INC
Active
Other names
AMG Heart & Vascular
Organization subpart
No
Provider details
NPI number
Authorized official
J. BRYAN FISSEL (VP-FINANCE)
(414) 465-3000
Entity
Organization
Contact information
Practice address
5045 W GRANDE MARKET DR, APPLETON, WI 54913-8517
(920) 886-9380
Mailing address
PO BOX 850005, MINNEAPOLIS, MN 55485-0005
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Enumeration date
03/14/2023
Last updated
03/27/2023
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