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Agnesian Healthcare Inc

Organization Active NPI Occupational Medicine Physician · Fond Du Lac, WI

NPI 1154947737 · NPPES record last updated Jun 5, 2024

Key facts

NPI
1154947737
Entity type
Organization (NPI type 2)
Primary specialty
Occupational Medicine Physician 2083X0100X
Legal business name
AGNESIAN HEALTHCARE INC
Practice address
250 Camelot Dr
Fond Du Lac, WI 54935-8029
Phone
(920) 923-7400
NPI assigned
Jun 19, 2020
Organization subpart
No

Authorized official

Name
Amy Grinnell
Title
VP-Finance, Cfo
Phone
(608) 260-3586

Corporate family (same tax ID) 26

Organizations that report the same tax identification number in the National Provider Directory.

View all 26

National Provider Directory

Tax ID family
Fond Du Lac Regional CL (27 organizations share this tax ID)

Locations

250 Camelot Dr
Fond du Lac, WI 54935
Phone (920) 923-7400

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 2083X0100X Yes

Addresses

Primary practice location

250 Camelot Dr
Fond Du Lac, WI 54935-8029

Mailing address

250 Camelot Dr
Fond Du Lac, WI 54935-8029

Other names

  • FOND DU LAC REGIONAL CLINC Doing business as

Other providers in Fond Du Lac, WI

All providers in Fond Du Lac, WI · Occupational Medicine Physician in Wisconsin

Sources for this page

Verify at the official NPI Registry.