Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

360 Medical Group Wisconsin SC

Organization Family Medicine Physician · NPI 1104750660

360 Medical Group Wisconsin SC provides Family Medicine Physician services in Appleton, Wisconsin. Registered with an NPI since 2026.

In the registry since
2026

Practice location Address checks out

2800 E Enterprise Ave Ste 333
Appleton, WI 54913-7889
Phone: (551) 372-9260
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1104750660
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official James Villar — Administrator · (551) 372-9260
NPI enumeratedJune 10, 2026
Last updated in NPPESJune 10, 2026
Certification dateJune 10, 2026
Mailing address2800 E Enterprise Ave Ste 333, Appleton, WI 54913-7889

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