Provider Demographics
NPI:1447205794
Name:FILZ, JOHN M (PA)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:M
Last Name:FILZ
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 3RD AVE.
Mailing Address - Street 2:
Mailing Address - City:HURLEY
Mailing Address - State:WI
Mailing Address - Zip Code:54534
Mailing Address - Country:US
Mailing Address - Phone:715-561-3962
Mailing Address - Fax:
Practice Address - Street 1:450 OLD ABE RD
Practice Address - Street 2:
Practice Address - City:LAC DU FLAMBEAU
Practice Address - State:WI
Practice Address - Zip Code:54538-9682
Practice Address - Country:US
Practice Address - Phone:715-588-3371
Practice Address - Fax:715-588-7884
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI568-023363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42923500Medicaid
WI42923500Medicaid