Provider Demographics
NPI:1225753122
Name:VILLAGE OF MAPLE BLUFF
Entity Type:Organization
Organization Name:VILLAGE OF MAPLE BLUFF
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF/PUBLIC SAFETY DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:LOY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-244-3390
Mailing Address - Street 1:18 OXFORD PL
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53704-5955
Mailing Address - Country:US
Mailing Address - Phone:608-244-3390
Mailing Address - Fax:
Practice Address - Street 1:18 OXFORD PL
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53704-5955
Practice Address - Country:US
Practice Address - Phone:608-244-3390
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-04
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical ServicesGroup - Single Specialty