Healthcare Provider Details

I. General information

NPI: 1861635971
Provider Name (Legal Business Name): MIDWEST ORTHOPEDIC SPECIALTY HOSPITAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2009
Last Update Date: 09/12/2024
Certification Date: 09/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10101 S 27TH ST FL 2
FRANKLIN WI
53132-7209
US

IV. Provider business mailing address

10101 S 27TH ST FL 2
FRANKLIN WI
53132-7209
US

V. Phone/Fax

Practice location:
  • Phone: 414-817-5800
  • Fax:
Mailing address:
  • Phone: 414-817-5800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code284300000X
TaxonomySpecial Hospital
License Number
License Number State

VIII. Authorized Official

Name: SHEILA GANSEMER
Title or Position: CEO
Credential:
Phone: 414-325-4589