Northern Wisconsin Bone & Joint
Organization Active NPI Orthopaedic Surgery Physician · Ontonagon, MI
NPI 1104142330 · NPPES record last updated Apr 29, 2010
Key facts
- NPI
- 1104142330
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Orthopaedic Surgery Physician 207X00000X
- Legal business name
- NORTHERN WISCONSIN BONE & JOINT
- Practice address
- 601 S 7TH St
Ontonagon, MI 49953-1448 - Phone
- (715) 358-1911
- Fax
- (715) 358-1912
- NPI assigned
- Apr 13, 2010
- Organization subpart
- No
Authorized official
- Name
- Dr. Kevin Lee Tadych, M.D.
- Title
- President/Owner
- Phone
- (715) 358-1911
National Provider Directory
Locations
7520 US Highway 51
Minocqua, WI 54548
Phone (715) 358-1911
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician |
207X00000X | Yes |
Addresses
Primary practice location
601 S 7TH St
Ontonagon, MI 49953-1448
Mailing address
7520 Hwy 51 S
Minocqua, WI 54548-8943
Phone (715) 358-1911
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1052540001 | Other | DMERC NUMBER | |
| 000044000 | Other | WI | MEDICARE ID-TYPE UNSPECIFIED |
| 21298800 | Medicaid | WI |
Other providers in Ontonagon, MI
- Ryan Kaiponen
- Colleen Marie Lundgren
- Eric Andrew Maki
- Maple Manor Nursing Center, Inc
- Suzanne J Miron
- Rachel Marie Nowicki
- Jacek Olszewski
- Ontonagon Community Health Center
- Michelle Outwater
- Brittany Ann Penegor
All providers in Ontonagon, MI · Orthopaedic Surgery Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 29, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.