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Contact Information

MCDONOUGH ORTHOPAEDIC AND SPORTS MEDICINE CENTER SC
410 DEWEY ST
WISCONSIN RAPIDS, WI54494-4715
 Phone: 715-421-5257
 Fax: 715-421-0111
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Orthopaedic Surgery

207X00000X 02 Physician/General Surgery
 

Family Medicine - Sports Medicine

207QS0010X 08 Physician/Family Practice
 

Surgery, Foot & Ankle

213ES0103X 48 Podiatry
Indicates primary specialty

NPI Profile & details for MCDONOUGH ORTHOPAEDIC AND SPORTS MEDICINE CENTER SC

NPI # 1609869460
LBN Legal business name MCDONOUGH ORTHOPAEDIC AND SPORTS MEDICINE CENTER SC
Authorized official WAYNE CHRISTIE - (VICE PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 08/26/2005
Last updated 03/05/2009 - About 17 years ago
Identifiers
WI Medicaid 32685600
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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