Provider Demographics
NPI:1720044407
Name:ORKFRITZ, JENNIFER Y (DO)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:Y
Last Name:ORKFRITZ
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2809 E HAMILTON AVE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54701-6863
Mailing Address - Country:US
Mailing Address - Phone:715-834-1555
Mailing Address - Fax:715-835-0263
Practice Address - Street 1:2809 E HAMILTON AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-6863
Practice Address - Country:US
Practice Address - Phone:715-834-1555
Practice Address - Fax:715-835-0263
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI46181-021208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1720044407Medicaid