Buffalo River Clinic SC
Organization Active NPI General Practice Physician · Osseo, WI
NPI 1316099161 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1316099161
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Physician 208D00000X
- Legal business name
- BUFFALO RIVER CLINIC SC
- Practice address
- 12830 Cox Lane
Osseo, WI 54758 - Phone
- (715) 597-6767
- Fax
- (715) 597-2819
- NPI assigned
- Jan 18, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Thomas Screnock, MD
- Title
- Ceo
- Phone
- (715) 597-6767
National Provider Directory
Locations
12830 Cox Ln
Osseo, WI 54758
Phone (715) 597-2683
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician |
208D00000X | Yes |
Addresses
Primary practice location
12830 Cox Lane
Osseo, WI 54758
Mailing address
PO Box 398
Osseo, WI 54758
Phone (715) 597-6767
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. 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.