Eau Claire Medical Clinic, S.C.

LBN: Eau Claire Medical Clinic, S.C.
Eau Claire Medical Clinic, S.C. is an health care organization with primary practice located at 703 W Hamilton Ave , Eau Claire WI 54701-6938. The organization recently has only one registered license in Laboratories / Clinical Medical Laboratory, which is considered as the primary health care specialty. Eau Claire Medical Clinic, S.C. can be contacted via phone (715) 839-9280, or through Kidess, Anton I via phone (715) 839-9280.

Contact Information

Primary practice address
703 W Hamilton Ave Eau Claire WI 54701-6938
Phone: (715) 839-9280
Fax: (715) 839-9348
Website:
Map and Directions
Authorized official contact:
Name: Kidess, Anton I Doctor of Medicine (MD)
Phone: (715) 839-9280

Health care specialties

SpecialtyCodeLicense #State
Laboratories / Clinical Medical Laboratory 291U00000X Wisconsin

Profile Details

NPI number 1962789362
LBN Legal business name Eau Claire Medical Clinic, S.C.
DBA Doing business as
Authorized official Kidess, Anton I Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Nov 14th, 2011
Last updated Nov 14th, 2011 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962789362 NPPES
Wisconsin MEDICAID 36203500
Wisconsin Other P00374505

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