MARSHFIELD CLINIC INC

Provider Demographics

• NPI: 1952347981
• Name: MARSHFIELD CLINIC INC
• Entity Type: Organization
• Organization Name: MARSHFIELD CLINIC INC
• Other - Org Name: MARSHFIELD MEDICAL CENTER PROFESSIONAL SERVICES
• Other - Org Type: Doing Business As
• Authorized Official - Title/Position: COO, AO
• Authorized Official - First Name: KATHLEEN
• Authorized Official - Last Name: BRESSLER
• Authorized Official - Phone: 715-975-6018
• Mailing Address - Street 1: 1000 N OAK AVE
• Mailing Address - Street 2: PROVIDER ENROLLMENT SHP FL2
• Mailing Address - City: MARSHFIELD
• Mailing Address - State: WI
• Mailing Address - Zip Code: 54449-5703
• Mailing Address - Country: US
• Mailing Address - Phone: 715-389-0660
• Practice Address - Street 1: 1000 N OAK AVE
• Practice Address - City: MARSHFIELD
• Practice Address - State: WI
• Practice Address - Zip Code: 54449-5703
• Practice Address - Country: US
• Practice Address - Phone: 715-387-5511
• EIN: <UNAVAIL>
• Is Organization Subpart?: Yes
• Parent Organization LBN: MARSHFIELD CLINIC HEALTH SYSTEM INC
• Parent Organization TIN: <UNAVAIL>
• Enumeration Date: 2006-06-20
• Last Update Date: 2023-11-28

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization
Yes	261Q00000X	Ambulatory Health Care Facilities	Clinic/Center
No	261QA1903X	Ambulatory Health Care Facilities	Clinic/Center	Ambulatory Surgical
No	291U00000X	Laboratories	Clinical Medical Laboratory

Provider Identifiers

State	Identifier ID	ID Type	Issuer
WI	000085953	Medicare PIN
WI	000085899	Medicare PIN
WI	000072200	Medicare PIN
WI	000072301	Medicare PIN
WI	000085997	Medicare PIN
WI	000085972	Medicare PIN
WI	000011050	Medicare PIN
WI	000083390	Medicare PIN
WI	00085972	Medicare PIN
WI	000092150	Medicare PIN
WI	000021410	Medicare PIN
WI	000085899	Medicare PIN
WI	000011085	Medicare PIN
WI	000021385	Medicare PIN
WI	000021395	Medicare PIN
WI	000083415	Medicare PIN
WI	000083450	Medicare PIN
WI	000085997	Medicare PIN
WI	000005105	Medicare PIN
WI	000021351	Medicare PIN