Tait D Fors (NPI# 1649293358, PAC ID# 6204830300) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is UROLOGY.
| Nation Provider ID (NPI) | 1649293358 |
| PAC ID by PECOS | 6204830300 |
| Professional Enrollment ID | I20060901000204 |
| Full Name | Tait D Fors |
| Organization Legal Name | WISCONSIN INSTITUTE OF UROLOGY SC |
| Address |
1265 W American Dr Suite 100 Neenah WI 54956-1405 |
| Phone Number | 9207227747 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF WISCONSIN MEDICAL SCHOOL |
| Graduation Year | 2000 |
| Primary Specialty | UROLOGY |
| Group Practice PAC ID | 6608058078 |
| Number of Group Practice Members | 12 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 520160 | THEDACARE REGIONAL MEDICAL CENTER - APPLETON INC |
| 521334 | RIVERSIDE MEDICAL CENTER |
| 520045 | THEDA CLARK MEDICAL CENTER |
| 521303 | WILD ROSE COMMUNITY MEMORIAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1265 W American Dr, Suite 100, Neenah, WI 54956-1405 | 9207227747 | WISCONSIN INSTITUTE OF UROLOGY SC |
| Organization Legal Name | WISCONSIN INSTITUTE OF UROLOGY SC |
| Physicians | 12 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Eric J Lawatsch | Urology | Wisconsin Institute of Urology Sc | 100 County Rd B, Shawano, WI 54166-7072 |
| Robert E Vlach Jr. | Urology | Wisconsin Institute of Urology Sc | 600 N Westhaven Dr, Oshkosh, WI 54904-6926 |
| Omar Atassi | Urology | Wisconsin Institute of Urology Sc | 2500 E Capitol Dr, Suite 2600, Appleton, WI 54911-8735 |
| Michael J Murphy | Urology | Wisconsin Institute of Urology Sc | 600 N Westhaven Dr, Oshkosh, WI 54904-6926 |
| Joshua Kavin Modder | Urology | Wisconsin Institute of Urology Sc | 100 County Rd B, Shawano, WI 54166-7072 |
| Heather K Beck | Nurse Practitioner | Wisconsin Institute of Urology Sc | 2500 E Capitol Dr, Suite 2600, Appleton, WI 54911-8735 |
| Tricia A Koch | Nurse Practitioner | Wisconsin Institute of Urology Sc | 600 N Westhaven Dr, Oshkosh, WI 54904-6926 |
| Daniel J Higgins | Urology | Wisconsin Institute of Urology Sc | 100 County Rd B, Shawano, WI 54166-7072 |
| Scott C Kolbeck | Urology | Wisconsin Institute of Urology Sc | 600 N Westhaven Dr, Oshkosh, WI 54904-6926 |
| Jessica M Lillie | Nurse Practitioner | Wisconsin Institute of Urology Sc | 2500 E Capitol Dr, Suite 2600, Appleton, WI 54911-8735 |
| Street Address |
1265 W AMERICAN DR SUITE 100 |
| City | NEENAH |
| State | WI |
| Zip | 54956-1405 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Gizell R Larson | Neurology | The Neuroscience Group of Northeast Wisconsin Sc | 1305 W American Dr, Neenah, WI 54956-1401 |
| Brianne M Wienkers | Physical Therapy | The Neuroscience Group of Northeast Wisconsin Sc | 1305 W American Dr, Neenah, WI 54956-1401 |
| Jill M Hietpas | Physician Assistant | The Neuroscience Group of Northeast Wisconsin Sc | 1305 W American Dr, Neenah, WI 54956-1401 |
| Brian T Bolinger | Diagnostic Radiology | Radiology Associates of The Fox Valley, Sc | 740 Deerwood Ave, Neenah, WI 54956-1601 |
| Curtis C Baltz | Internal Medicine | Thedacare Incorporated | 333 N Green Bay Rd, Neenah, WI 54956-1954 |
| Megan J Kane | Family Medicine | Thedacare Incorporated | 333 N Green Bay Rd, Neenah, WI 54956-1954 |
| Richard D Klamm | Family Medicine | Thedacare Incorporated | 333 N Green Bay Rd, Neenah, WI 54956-1954 |
| Jennifer A Norden | Internal Medicine | Thedacare Incorporated | 333 N Green Bay Rd, Neenah, WI 54956-1954 |
| Venkata S Udayagiri | Family Medicine | Thedacare Incorporated | 333 N Green Bay Rd, Neenah, WI 54956-1954 |
| Daniel L Long | Neurology | The Neuroscience Group of Northeast Wisconsin Sc | 1305 W American Dr, Neenah, WI 54956-1993 |
| Find all physicians in zip 54956 | |||
| City | NEENAH |
| Zip Code | 54956 |
| Specialty | UROLOGY |
| City + Specialty | NEENAH + UROLOGY |
Please comment or provide details below to improve the information on Tait D Fors.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.