Fors, Tait D
Fors, Tait D is an individual health care provider with primary practice located at 1265 W American Dr Ste 100 , Neenah WI 54956. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Fors, Tait D can be contacted via phone (920) 722-7747.Contact Information
Primary practice address
1265 W American Dr Ste 100
Neenah WI 54956
Phone: (920) 722-7747
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Urology | 208800000X | 49453 | Wisconsin |
Profile Details
| NPI number | 1649293358 |
|---|---|
| LBN Legal business name | Fors, Tait D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 25th, 2006 |
| Last updated | Dec 18th, 2019 - about 7 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1649293358 | NPPES |
| Wisconsin | MEDICAID | 1649293358 | |
| Wisconsin | Other | 49453-20 |
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