Provider Demographics
NPI:1508032004
Name:FOX VALLEY WOMEN'S HEALTH SERVICES, SC
Entity Type:Organization
Organization Name:FOX VALLEY WOMEN'S HEALTH SERVICES, SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:L
Authorized Official - Last Name:SENSOR
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:920-223-0220
Mailing Address - Street 1:200 E WASHINGTON ST
Mailing Address - Street 2:PO BOX 8031
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54912-8031
Mailing Address - Country:US
Mailing Address - Phone:920-996-1345
Mailing Address - Fax:
Practice Address - Street 1:2400 WITZEL AVE
Practice Address - Street 2:
Practice Address - City:OSHKOSH
Practice Address - State:WI
Practice Address - Zip Code:54904
Practice Address - Country:US
Practice Address - Phone:920-233-1540
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-05
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty