Healthcare Provider Details

I. General information

NPI: 1760560148
Provider Name (Legal Business Name): OAK CREEK URGENT CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 08/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8201 S HOWELL AVE STE 400
OAK CREEK WI
53154-8336
US

IV. Provider business mailing address

8201 S HOWELL AVE STE 400
OAK CREEK WI
53154-8336
US

V. Phone/Fax

Practice location:
  • Phone: 414-570-1122
  • Fax: 414-570-1120
Mailing address:
  • Phone: 414-570-1122
  • Fax: 414-570-1120

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number261QU0200X
License Number StateWI

VIII. Authorized Official

Name: DR. CRAIG LINDSEY SKOLD
Title or Position: OWNER/PHYSICIAN
Credential: M.D.
Phone: 414-570-1122