Provider Demographics
NPI:1952863359
Name:FOX VALLEY SURGICAL ASSOCIATES
Entity Type:Organization
Organization Name:FOX VALLEY SURGICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:CALLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SPRINGSTROH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-731-8131
Mailing Address - Street 1:1818 N MEADE ST STE 240W
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54911-3454
Mailing Address - Country:US
Mailing Address - Phone:920-731-8131
Mailing Address - Fax:
Practice Address - Street 1:1818 N MEADE ST STE 240W
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54911-3454
Practice Address - Country:US
Practice Address - Phone:920-731-8131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-03
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Multi-Specialty