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Organization

INTERVENTIONAL PAIN SPECIALISTS OF WISCONSIN, SC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOHN K BRENDEL JR. MD (OWNER)
(715) 234-7246
Entity
Organization

Contact information

Practice address
2021 CENEX DR UNIT J, RICE LAKE, WI 54868-1892
(715) 234-7246
(715) 234-7242
Mailing address
2021 CENEX DR UNIT J, RICE LAKE, WI 54868-1892
(715) 234-7246
(715) 234-7242

Taxonomy

Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
34036
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
31913700
WI
01
34036
WI LICENSE NUMBER
WI
01
397524621000
BLUE CROSS WI
WI
Enumeration date
09/14/2006
Last updated
04/15/2024
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