Provider Demographics
NPI:1699785816
Name:SURGICAL ASSOCIATES SAUK-PRAIRIE, LLP
Entity type:Organization
Organization Name:SURGICAL ASSOCIATES SAUK-PRAIRIE, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:REINHARDT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-643-2431
Mailing Address - Street 1:35 PRAIRIE AVE
Mailing Address - Street 2:STE 315
Mailing Address - City:PRAIRIE DU SAC
Mailing Address - State:WI
Mailing Address - Zip Code:53578-1500
Mailing Address - Country:US
Mailing Address - Phone:608-643-2431
Mailing Address - Fax:608-643-0048
Practice Address - Street 1:35 PRAIRIE AVE
Practice Address - Street 2:STE 315
Practice Address - City:PRAIRIE DU SAC
Practice Address - State:WI
Practice Address - Zip Code:53578-1500
Practice Address - Country:US
Practice Address - Phone:608-643-2431
Practice Address - Fax:608-643-0048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI32815900Medicaid
WI57150Medicare ID - Type Unspecified