ASCENSION MEDICAL GROUP-FOX VALLEY WISCONSIN, INC; NPI #1073970984

Contact Information

ASCENSION MEDICAL GROUP-FOX VALLEY WISCONSIN, INC

1610 HOOVER ST
NEW HOLSTEIN, WI 53061

Phone: 920-849-3800
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Multi-Specialty	261QM1300X	70	Clinic or Group Practice

Indicates primary specialty

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NPI Profile & details for ASCENSION MEDICAL GROUP-FOX VALLEY WISCONSIN, INC

NPI Number 1073970984

LBN Legal business name ASCENSION MEDICAL GROUP-FOX VALLEY WISCONSIN, INC

Authorized official DAVID JIROVEC - (SR FINANCE DIRECTOR - MEDICAL GROUP)

Entity Organization

Organization subpart ¹ No

Enumeration date 01/22/2016

Last updated 05/18/2026 - About 3 weeks ago

Identifiers

Medicaid

32752000

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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