Basic Information
| Provider Information | |||||||||
| NPI: | 1902229040 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | APPLETON MEDICAL CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 157 PARK ST STE 5 | ||||||||
| Address2: | |||||||||
| City: | BANGOR | ||||||||
| State: | ME | ||||||||
| PostalCode: | 044015000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2079920410 | ||||||||
| FaxNumber: | 2079920414 | ||||||||
| Practice Location | |||||||||
| Address1: | 658 MAIN RD N | ||||||||
| Address2: | |||||||||
| City: | HAMPDEN | ||||||||
| State: | ME | ||||||||
| PostalCode: | 044441904 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2079920410 | ||||||||
| FaxNumber: | 2079920414 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/25/2014 | ||||||||
| LastUpdateDate: | 01/25/2014 | ||||||||
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| AuthorizedOfficialLastName: | WILLARD | ||||||||
| AuthorizedOfficialFirstName: | FRANK | ||||||||
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| AuthorizedOfficialTitleorPosition: | CHAIRMAN OF THE BOARD | ||||||||
| AuthorizedOfficialTelephone: | 2079910410 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QP2300X | Y | Ambulatory Health Care Facilities | Clinic/Center | Primary Care |
No ID Information.