Provider Demographics
NPI:1003008152
Name:OAKLEAF MEDICAL NETWORK
Entity Type:Organization
Organization Name:OAKLEAF MEDICAL NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:PELLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-839-9833
Mailing Address - Street 1:3430 OAKWOOD MALL DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54701-3850
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3430 OAKWOOD MALL DR
Practice Address - Street 2:SUITE 400
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-3850
Practice Address - Country:US
Practice Address - Phone:715-839-9833
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-13
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital