Healthcare Provider Details

I. General information

NPI: 1619431756
Provider Name (Legal Business Name): VISION ANESTHESIA, SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2019
Last Update Date: 01/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10200 W INNOVATION DR STE 700
MILWAUKEE WI
53226-4827
US

IV. Provider business mailing address

225 S EXECUTIVE DR
BROOKFIELD WI
53005-4257
US

V. Phone/Fax

Practice location:
  • Phone: 414-302-9196
  • Fax: 262-439-7683
Mailing address:
  • Phone: 262-787-4050
  • Fax: 262-439-7683

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MANFRED M KREUZPAINTNER
Title or Position: PARTNER/OWNER
Credential: MD
Phone: 262-787-4050