FOND DU LAC SURGERY CENTER, LLC – NPI #1104874247
Clinic/Center

FOND DU LAC SURGERY CENTER, LLC is an AHC clinic located in FOND DU LAC, WI. NPPES has assigned the NPI number 1104874247 to FOND DU LAC SURGERY CENTER, LLC on May 04, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QA1903X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Ambulatory Surgical

The NPI profile was previously updated about 19 years ago on Aug 29, 2007. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for FOND DU LAC SURGERY CENTER, LLC below.

NPI Profile for
FOND DU LAC SURGERY CENTER, LLC

NPI Number
1104874247
Enumeration Date

(more than 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
FOND DU LAC SURGERY CENTER, LLC
Primary location
421 CAMELOT DRIVE
FOND DU LAC, WI 54935
Phone: (920) 926-5407 Fax:
Mailing address
430 E DIVISION ST
FOND DU LAC, WI 54935-4560
Phone: (920) 926-4472 Fax: (920) 926-8885
Organization Subpart
No
Authorized Official
STEVEN LITTLE
SVP & CFO
Phone: (920) 926-5402
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QA1903X
- Clinic/Center / Ambulatory Surgical (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.