Fond Du Lac County

Specialty details in registry · Fond Du Lac, WI

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At a glance

459 East First Street, Fond Du Lac, WI 54935-4505

NPPES record updated Oct 1, 2008. Public records can lag behind changes at a practice.

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Insurance participation and appointment availability are not established by these public records.

Practice location

459 East First Street
Fond Du Lac, WI 54935-4505
Professional details: NPI, taxonomy & registry record
NPI1003951468
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Registry details

Primary taxonomy
Specialty details in registry
Taxonomy code
314000000X
Enumeration date
Feb 21, 2007
Record updated
Oct 1, 2008
More registry details
Provider type
Organization · Type 2
Other reported name
<UNAVAIL>

Reported taxonomies and licenses

Specialty details in registry

314000000X · Primary

License reported: 2383 WI

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

459 East First Street
Fond Du Lac, WI 54935-4505
Phone
(920) 929-3500
Fax
(920) 929-7046
Mailing address
459 EAST FIRST STREET

FOND DU LAC, WI 549354505
Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.

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