| NPI | 1588623060 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RALPH FAIRCHILD Physician/Owner 920-457-6750 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care |
| 208C00000X Colon & Rectal Surgery | |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2008-05-20 |