Provider Demographics
NPI:1972338283
Name:REFORMEDICINE, S.C.
Entity type:Organization
Organization Name:REFORMEDICINE, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:USHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:715-514-2827
Mailing Address - Street 1:3004 GOLF ROAD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54701
Mailing Address - Country:US
Mailing Address - Phone:715-514-2827
Mailing Address - Fax:888-606-1323
Practice Address - Street 1:VILLAGE SHOPS AT LAKE HALLIE
Practice Address - Street 2:3026 COMMERCIAL BLVD
Practice Address - City:CHIPPEWA FALLS
Practice Address - State:WI
Practice Address - Zip Code:54729
Practice Address - Country:US
Practice Address - Phone:715-895-6215
Practice Address - Fax:888-606-1323
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REFORMEDICINE, S.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-09-05
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty