Healthcare Provider Details

I. General information

NPI: 1124075981
Provider Name (Legal Business Name): MEDICAL CONSULTANTS, LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2006
Last Update Date: 08/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 W KINNICKINNIC RIVER PKWY SUITE 516
MILWAUKEE WI
53215-3677
US

IV. Provider business mailing address

2901 W KINNICKINNIC RIVER PKWY SUITE 516
MILWAUKEE WI
53215-3677
US

V. Phone/Fax

Practice location:
  • Phone: 414-385-3086
  • Fax: 414-672-1985
Mailing address:
  • Phone: 414-385-3086
  • Fax: 414-672-1985

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: NOEL P. RODDY
Title or Position: BUSINESS MANAGER
Credential:
Phone: 414-385-3086