Healthcare Provider Details

I. General information

NPI: 1497708143
Provider Name (Legal Business Name): JOHN S RHEE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 11/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9200 W WISCONSIN AVE DEPARTMENT OF OTOLARYNGOLOGY
MILWAUKEE WI
53226-3522
US

IV. Provider business mailing address

9200 W WISCONSIN AVE DEPARTMENT OF OTOLARYNGOLOGY
MILWAUKEE WI
53226-3522
US

V. Phone/Fax

Practice location:
  • Phone: 414-805-5580
  • Fax: 414-805-8324
Mailing address:
  • Phone: 414-805-5580
  • Fax: 414-805-8324

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License Number40716
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: