Earll, Patrick Gordon

Earll, Patrick Gordon is an individual health care provider with primary practice located at 3501 Cranberry Blvd , Weston WI 54476. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Earll, Patrick Gordon can be contacted via phone (715) 847-3542.

Contact Information

Primary practice address
3501 Cranberry Blvd Weston WI 54476
Phone: (715) 847-3542
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1329 Wisconsin

Profile Details

NPI number 1073611802
LBN Legal business name Earll, Patrick Gordon
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073611802 NPPES
Wisconsin MEDICAID 41923900

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