Provider Demographics
NPI:1598734956
Name:WARBASSE, ERIC A (MD)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:A
Last Name:WARBASSE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 26TH ST
Mailing Address - Street 2:SAUK PRAIRIE MEMORIAL HOSPITAL AND CLINICS
Mailing Address - City:PRAIRIE DU SAC
Mailing Address - State:WI
Mailing Address - Zip Code:53578
Mailing Address - Country:US
Mailing Address - Phone:608-643-7206
Mailing Address - Fax:
Practice Address - Street 1:260 26TH ST
Practice Address - Street 2:SAUK PRAIRIE MEMORIAL HOSPITAL AND CLINICS
Practice Address - City:PRAIRIE DU SAC
Practice Address - State:WI
Practice Address - Zip Code:53578
Practice Address - Country:US
Practice Address - Phone:608-643-7206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI44929207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine