Provider Demographics
NPI:1508968397
Name:CARDIAC RHYTHM SPECIALISTS SC
Entity Type:Organization
Organization Name:CARDIAC RHYTHM SPECIALISTS SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:E
Authorized Official - Last Name:BJORN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-962-7500
Mailing Address - Street 1:2015 E NEWPORT AVE
Mailing Address - Street 2:SUITE 703
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53211-2984
Mailing Address - Country:US
Mailing Address - Phone:414-962-7500
Mailing Address - Fax:414-962-7501
Practice Address - Street 1:2700 W 9TH AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:OSHKOSH
Practice Address - State:WI
Practice Address - Zip Code:54904-7247
Practice Address - Country:US
Practice Address - Phone:414-962-7500
Practice Address - Fax:414-962-7501
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARDIAC RHYTHM SPECIALISTS SC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-02
Last Update Date:2007-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac ElectrophysiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI21282500Medicaid
DB9261OtherMEDICARE RR GROUP NUMBER