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Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Multi-Specialty |
261QM1300X | 70 | Clinic or Group Practice |
| NPI Number | 1164680468 |
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| 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 | 05/23/2008 | ||||
| Last updated | 05/19/2026 - About 3 weeks ago | ||||
| Identifiers |
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ASCENSION MEDICAL GROUP-FOX VALLEY WISCONSIN, INC