Provider Demographics
NPI:1952874141
Name:OAKLEAF CLINICS INC
Entity Type:Organization
Organization Name:OAKLEAF CLINICS INC
Other - Org Name:OAKLEAF CLINICS, AMY LUDWIKOWSKI, MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:LONGBELLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:715-836-9242
Mailing Address - Street 1:719 W HAMILTON AVE STE B
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54701-6970
Mailing Address - Country:US
Mailing Address - Phone:715-552-9784
Mailing Address - Fax:
Practice Address - Street 1:431 E CLAIREMONT AVE STE C
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-6480
Practice Address - Country:US
Practice Address - Phone:715-514-5724
Practice Address - Fax:715-514-5734
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OAKLEAF CLINICS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-01-10
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty