Basic Information
| Provider Information | |||||||||
| NPI: | 1780014407 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ASPIRUS WAUSAU HOSPITAL, INC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | ASPIRUS IMAGING-WESTHILL | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1008 | ||||||||
| Address2: | |||||||||
| City: | WAUSAU | ||||||||
| State: | WI | ||||||||
| PostalCode: | 544021008 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7158472229 | ||||||||
| FaxNumber: | 7158431207 | ||||||||
| Practice Location | |||||||||
| Address1: | 3200 WESTHILL DR | ||||||||
| Address2: | |||||||||
| City: | WAUSAU | ||||||||
| State: | WI | ||||||||
| PostalCode: | 544014705 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7158470077 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/15/2013 | ||||||||
| LastUpdateDate: | 11/15/2013 | ||||||||
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| AuthorizedOfficialLastName: | SCZYGELSKI | ||||||||
| AuthorizedOfficialFirstName: | SIDNEY | ||||||||
| AuthorizedOfficialMiddleName: | C | ||||||||
| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 7158472121 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 261QR0200X | 188 | WI | Y | Ambulatory Health Care Facilities | Clinic/Center | Radiology |
No ID Information.