Provider Demographics
NPI:1780766998
Name:ASPIRUS SPECIALISTS, INC.
Entity type:Organization
Organization Name:ASPIRUS SPECIALISTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:F
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:DANNER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:715-847-2975
Mailing Address - Street 1:PO BOX 1223
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54402-1223
Mailing Address - Country:US
Mailing Address - Phone:715-847-2304
Mailing Address - Fax:
Practice Address - Street 1:215 N 28TH AVE
Practice Address - Street 2:
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401-4100
Practice Address - Country:US
Practice Address - Phone:715-847-2866
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI261QX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0200XAmbulatory Health Care FacilitiesClinic/CenterOncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI21253300Medicaid
WI5465450001OtherDMEPOS
WI=========006OtherTRICARE HEALTHNET