Provider Demographics
NPI:1588831366
Name:OSHKOSH HEALTH SERVICES DIVISION
Entity Type:Organization
Organization Name:OSHKOSH HEALTH SERVICES DIVISION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:SPIEGEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-236-5031
Mailing Address - Street 1:215 CHURCH AVE
Mailing Address - Street 2:
Mailing Address - City:OSHKOSH
Mailing Address - State:WI
Mailing Address - Zip Code:54901-4747
Mailing Address - Country:US
Mailing Address - Phone:920-236-5030
Mailing Address - Fax:920-236-5186
Practice Address - Street 1:215 CHURCH AVE
Practice Address - Street 2:
Practice Address - City:OSHKOSH
Practice Address - State:WI
Practice Address - Zip Code:54901-4747
Practice Address - Country:US
Practice Address - Phone:920-236-5030
Practice Address - Fax:920-236-5186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43085100Medicaid