Provider Demographics
NPI:1306614987
Name:FOX VALLEY PSYCHIATRY LTD.
Entity type:Organization
Organization Name:FOX VALLEY PSYCHIATRY LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:SOUCY
Authorized Official - Last Name:RUEFF
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:920-882-7780
Mailing Address - Street 1:4321 W COLLEGE AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54914-3968
Mailing Address - Country:US
Mailing Address - Phone:920-882-7780
Mailing Address - Fax:920-214-1187
Practice Address - Street 1:4321 W COLLEGE AVE STE 200
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54914-3968
Practice Address - Country:US
Practice Address - Phone:920-882-7780
Practice Address - Fax:920-214-1187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-13
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty