Fond Du Lac Psychiatry Llc

LBN: Fond Du Lac Psychiatry Llc
Fond Du Lac Psychiatry Llc is an health care organization with primary practice located at 1020 S Main St Suite A, Fond Du Lac WI 54935-6102. The organization recently has only one registered license in Ambulatory Health Care Facilities / Medical Specialty, which is considered as the primary health care specialty. Fond Du Lac Psychiatry Llc can be contacted via phone (920) 923-9054, or through Junig, Jeffrey Thomas via phone (920) 923-9054.

Contact Information

Primary practice address
1020 S Main St Suite A Fond Du Lac WI 54935-6102
Phone: (920) 923-9054
Fax: (920) 322-9193
Website:
Map and Directions
Authorized official contact:
Name: Junig, Jeffrey Thomas MD PHD
Phone: (920) 923-9054

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Medical Specialty 261QM2500X 32668-020 Wisconsin

Profile Details

NPI number 1144466608
LBN Legal business name Fond Du Lac Psychiatry Llc
DBA Doing business as
Authorized official Junig, Jeffrey Thomas MD PHD
Entity Organization
Organization subpart 1 No
Enumeration date Jan 5th, 2009
Last updated Jan 5th, 2009 - about 15 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 1144466608 NPPES
Wisconsin MEDICAID 31769900

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