Provider Demographics
NPI:1710075429
Name:ROGERS AND NELSON SURGICAL ASSOCIATES, S.C.
Entity Type:Organization
Organization Name:ROGERS AND NELSON SURGICAL ASSOCIATES, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING CLERK
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:J
Authorized Official - Last Name:CHIER
Authorized Official - Suffix:
Authorized Official - Credentials:RHIT
Authorized Official - Phone:920-361-5765
Mailing Address - Street 1:225 MEMORIAL DR
Mailing Address - Street 2:SUITE 2000
Mailing Address - City:BERLIN
Mailing Address - State:WI
Mailing Address - Zip Code:54923-1243
Mailing Address - Country:US
Mailing Address - Phone:920-361-5340
Mailing Address - Fax:920-361-5335
Practice Address - Street 1:933 NEWBURY ST
Practice Address - Street 2:
Practice Address - City:RIPON
Practice Address - State:WI
Practice Address - Zip Code:54971-1730
Practice Address - Country:US
Practice Address - Phone:920-748-0488
Practice Address - Fax:920-748-0475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI22270 001Medicare ID - Type Unspecified
WI22270 002Medicare ID - Type Unspecified