FOX VALLEY HEMATOLOGY & ONCOLOGY, S.C.


Address: N3063 Cty Qq, Waupaca, WI 54981-9796
Phone: 7156024900

FOX VALLEY HEMATOLOGY & ONCOLOGY, S.C. (NPI# 1770706624) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1770706624
Entity Type Organization
Organization Name FOX VALLEY HEMATOLOGY & ONCOLOGY, S.C.
Practice Address N3063 Cty Qq
Waupaca
WI 54981-9796
Mailing Address 3232 N Ballard Rd
Suite 200
Appleton
WI 54911-8804
Practice Telephone 7156024900
Practice Fax Number 9207491172
Mailing Telephone 9207499668
Mailing Fax Number 9207345307
Enumeration Date 2007-04-10
Last Update Date 2017-02-03
Authorized Official Name TIMOTHY F GOGGINS (PHYSICIAN/CHIEF MEDICAL OFFICER)
Authorized Official Telephone 9207491171
Authorized Official Credential M.D.
Is Organization Subpart Y
Parent Organization Name FOX VALLEY HEMATOLOGY & ONCOLOGY, S.C.

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207RH0003X Internal Medicine
Specialization: Hematology & Oncology
Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
WI DME MAC 0886830002 01
WI 32802700 05

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1649716358 Fox Valley Hematology & Oncology, S.c. Internal Medicine 1716 Lawrence Dr, De Pere, WI 54115-9108 2017-01-19
1003039959 Fox Valley Hematology & Oncology, S.c. Internal Medicine 1370 N Shawano St E, New London, WI 54961-2155 2007-04-10
1124241724 Fox Valley Hematology & Oncology, S.c. Internal Medicine 1415 E Green Bay St, Suite 141, Shawano, WI 54166-3879 2007-04-11
1063635910 Fox Valley Hematology & Oncology, S.c. Internal Medicine 100 Theda Clark Medical Plz, Suite 340, Neenah, WI 54956-2763 2007-04-10
1255454617 Fox Valley Hematology & Oncology, S.c. Internal Medicine 933 Newbury St, Upper Level, Ripon, WI 54971-1730 2007-04-09
1942323407 Fox Valley Hematology & Oncology, S.c. Non-Pharmacy Dispensing Site 491 S Washburn St, Suite 100, Oshkosh, WI 54904-6733 2007-04-09
1063535524 Fox Valley Hematology & Oncology, S.c. Internal Medicine 3925 N Gateway Dr, Appleton, WI 54913-7863 2007-04-09
1497878854 Fox Valley Hematology & Oncology, S.c. Internal Medicine 614 Memorial Dr, Calumet Medical Center, Chilton, WI 53014-1568 2007-04-09
1912020371 Fox Valley Hematology & Oncology, S.c. Internal Medicine 191 Memorial Dr, Berlin Memorial Hospital, Berlin, WI 54923-1241 2007-04-09
1407868334 Fox Valley Hematology & Oncology, S.c. Physiological Laboratory 3925 N Gateway Dr, Appleton, WI 54913-7863 2006-08-12

Office Location

Street Address N3063 CTY QQ
City WAUPACA
State WI
Zip Code 54981-9796

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1750743365 Kimberly Marie Kraeger Counselor Waupaca County Dhhs, 811 Harding St, Waupaca, WI 54981 2016-03-23
1619211596 Kari Anna Esbensen Counselor N2919 Cty Qq, Waupaca, WI 54981 2012-11-16
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Taxonomy Information

Taxonomy Code 207RH0003X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Hematology & Oncology

Taxonomy Definition

An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.
Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source]
- Additional Resources: http://www.osteopathic.org/certification

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1649716358 Fox Valley Hematology & Oncology, S.c. Internal Medicine 1716 Lawrence Dr, De Pere, WI 54115-9108 2017-01-19
1629416409 Christopher Robert D'angelo Internal Medicine 958 Basswood Ave, Verona, WI 53593-8220 2013-06-13
1811250426 Michael Bade Wheeler Internal Medicine 28391 Essential Road, Merton, WI 53056-0012 2012-06-19
1366732752 Ezzideen Barjes Alrawi Internal Medicine 111 Ann St, Waukesha, WI 53188-2263 2011-04-19
1063730042 Bradley C Heraly Internal Medicine 1726 Shawano Avenue, Green Bay Oncology, Green Bay, WI 54303 2010-05-14
1528276417 Kelly Jo Cooke Internal Medicine 721 American Ave Ste 508, Prohealth Care Medical Associates Inc., Waukesha, WI 53188-5071 2007-05-21
1205044773 Derek Steven Serna Internal Medicine 1683 Whistling Hill Cir, Hartland, WI 53029 2007-05-18
1003039959 Fox Valley Hematology & Oncology, S.c. Internal Medicine 1370 N Shawano St E, New London, WI 54961-2155 2007-04-10
1356486591 Galen R Hasler Internal Medicine 350 S Hamilton St, 203, Madison, WI 53703-3861 2007-02-21
1639259823 Santosh Gowda Internal Medicine N34w23344 Hunters Ct Apt 303, Pewaukee, WI 53072-6213 2006-10-16
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Competitor

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City WAUPACA
Zip Code 54981

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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