WOLFE MOBILE MEDICAL LLC


Address: 510 Grey Fox Run, Watertown, WI 53094-5901
Phone: 9202535851

WOLFE MOBILE MEDICAL LLC (NPI# 1265611586) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1265611586
Entity Type Organization
Organization Name WOLFE MOBILE MEDICAL LLC
Practice Address 510 Grey Fox Run
Watertown
WI 53094-5901
Practice Telephone 9202535851
Mailing Telephone 9202535851
Enumeration Date 2007-11-02
Last Update Date 2007-11-02
Authorized Official Name DR. THOMAS ANDREW WOLFE (MEMBER)
Authorized Official Telephone 9202535851
Authorized Official Credential MD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QP2300X Clinic/Center
Specialization: Primary Care
29319-020 WI Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
NPI ENUMERATOR 1003998394 01
WI 31425500 05
WI WI, DEPT REGULATION & LIS 29319 01

Office Location

Street Address 510 GREY FOX RUN
City WATERTOWN
State WI
Zip Code 53094-5901

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Taxonomy Information

Taxonomy Code 261QP2300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Primary Care

Taxonomy Definition

Definition to come...

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Competitor

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City WATERTOWN
Zip Code 53094

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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