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Organization

AMBULATORY SURGICAL CENTER, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ERIC LARSON M.D. (MEDICAL DIRECTOR)
(920) 236-3550
Entity
Organization

Contact information

Practice address
2120 S WASHBURN ST, OSHKOSH, WI 54904
(920) 236-3550
(920) 238-3169
Mailing address
2120 S WASHBURN ST, OSHKOSH, WI 54904
(920) 236-3550
(920) 238-3169

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
41911700
WI
01
NPI 1275513467
ERIC M LARSON
01
NPI 1437244621
BRADLEY N LEMKE
01
NPI 1619957230
STEPHEN J MERFELD
Enumeration date
07/25/2006
Last updated
02/09/2026
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