Provider Demographics
NPI:1790059996
Name:ASPIRUS SPECIALISTS, INC.
Entity Type:Organization
Organization Name:ASPIRUS SPECIALISTS, INC.
Other - Org Name:ASPIRUS WAUSAU FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR VP/COO
Authorized Official - Prefix:
Authorized Official - First Name:FORREST
Authorized Official - Middle Name:D
Authorized Official - Last Name:DANNER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:715-847-2975
Mailing Address - Street 1:425 WIND RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54401-4149
Mailing Address - Country:US
Mailing Address - Phone:715-675-3391
Mailing Address - Fax:715-675-4253
Practice Address - Street 1:425 WIND RIDGE DR
Practice Address - Street 2:
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401-4149
Practice Address - Country:US
Practice Address - Phone:715-675-3391
Practice Address - Fax:715-675-4253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-06
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty