Organization
EAU CLAIRE GI ASSOCIATES SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY FOGELTANZ (PRACTICE MANAGER)
(715) 552-7303
Entity
Organization
Contact information
Practice address
4109 OAKWOOD HILLS PARKWAY, EAU CLAIRE, WI 54701-8888
(715) 552-7303
(715) 552-7355
Mailing address
4109 OAKWOOD HILLS PARKWAY, EAU CLAIRE, WI 54701-8888
(715) 552-7303
(715) 552-7355
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
37801-020
WI
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
=========
TAX ID NUMBER
WI
01
—
CH7600
RAILROAD MEDICARE
WI
Enumeration date
11/13/2006
Last updated
05/21/2025
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