Provider Demographics
NPI:1699899740
Name:OSHKOSH ORTHOPAEDICS, S.C.
Entity type:Organization
Organization Name:OSHKOSH ORTHOPAEDICS, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LIZ
Authorized Official - Middle Name:A
Authorized Official - Last Name:RILLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-231-2828
Mailing Address - Street 1:2130 W 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:OSHKOSH
Mailing Address - State:WI
Mailing Address - Zip Code:54904-8044
Mailing Address - Country:US
Mailing Address - Phone:920-231-2828
Mailing Address - Fax:920-231-2848
Practice Address - Street 1:2130 W 9TH AVE
Practice Address - Street 2:
Practice Address - City:OSHKOSH
Practice Address - State:WI
Practice Address - Zip Code:54904-8044
Practice Address - Country:US
Practice Address - Phone:920-231-2828
Practice Address - Fax:920-231-2848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI31837400Medicaid