NPI 1073105896

Medexpress Primary Care Wisconsin, S.C.

Organisation General Practice Physician Waupaca, WI

Practice location

Address: N2610 State Road 22 STE 2, Waupaca, WI 54981-8264
Phone: (304) 225-2500
Mailing address: 1001 Consol Energy Dr, Canonsburg, PA 15317-6506

Authorised official

Name: Brett Gall
Title: Director Payor Contracting
Phone: (304) 225-2500

Registered specialties

General Practice Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208D00000X

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Registry record

NPI: 1073105896
Entity type: Organization
NPI issued: 4 Feb 2021
Record last updated: 4 Feb 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.