Willett, Thomas Rice

Willett, Thomas Rice is an sole proprietor health care provider with primary practice located at N6205 Busse Rd , Green Lake WI 54941-8500. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Willett, Thomas Rice can be contacted via phone (920) 294-3444.

Contact Information

Primary practice address
N6205 Busse Rd Green Lake WI 54941-8500
Phone: (920) 294-3444
Fax: (920) 294-6660
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 17659 Wisconsin

Profile Details

NPI number 1902806243
LBN Legal business name Willett, Thomas Rice
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 28th, 2005
Last updated Dec 31st, 2009 - about 17 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 1902806243 NPPES
Wisconsin Other 391253020 TAX IDENTIFICATION NUMBER
Wisconsin MEDICAID 30020000 TAX IDENTIFICATION NUMBER
Wisconsin Other 391253020013 TAX IDENTIFICATION NUMBER

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