Provider Demographics
NPI:1205381555
Name:MARSHFIELD CLINIC HHJV, LLC
Entity Type:Organization
Organization Name:MARSHFIELD CLINIC HHJV, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF DEVELOPMENT OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:TYSON
Authorized Official - Middle Name:
Authorized Official - Last Name:BICKLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-635-0297
Mailing Address - Street 1:1900 CHURCH ST
Mailing Address - Street 2:SUITE 511
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2234
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1000 N OAK AVE
Practice Address - Street 2:MED-PEDS IF2
Practice Address - City:MARSHFIELD
Practice Address - State:WI
Practice Address - Zip Code:54449-5703
Practice Address - Country:US
Practice Address - Phone:715-221-5846
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-16
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management