Conrad E Eastwold, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

21662 Issued in WI

Practice address

1700 W Stout St
Rice Lake, WI 54868-5000

Phone

(715) 236-8100

NPI assigned

Aug 24, 2006

Last updated

Sep 1, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251763200000",
    "number": "1780791046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N OAK AVE",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544495777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 W STOUT ST",
            "city": "RICE LAKE",
            "state": "WI",
            "postal_code": "548685000",
            "telephone_number": "715-236-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EASTWOLD",
        "first_name": "CONRAD",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2009-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "21662",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30183600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ricky Charles Draeger, DC
• Courtney Drury, OTR
• Ronald Lee Dudash, MSCCCSLP
• Janaan M. Duellman, PA-C
• Clare Duncan, AU.D
• Morgan C Ebner, PT
• Rebecca Jenn Eder, PA-C
• Kathleen Elizabeth Effertz, D.C.
• Ryan James Effertz
• Elite Therapy Institute LLC (ET I Wound Healing Center)

• Internal Medicine Physician in Rice Lake, WI
• Providers in Rice Lake, WI by specialty
• Internal Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.