Healthcare Provider Details

I. General information

NPI: 1699653485
Provider Name (Legal Business Name): OAK MEDICAL WOUND SERVICES SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2025
Last Update Date: 08/21/2025
Certification Date: 08/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

N20W22961 WATERTOWN RD
WAUKESHA WI
53186-1308
US

IV. Provider business mailing address

N20W22961 WATERTOWN RD
WAUKESHA WI
53186-1308
US

V. Phone/Fax

Practice location:
  • Phone: 262-875-5070
  • Fax:
Mailing address:
  • Phone: 262-875-5070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BRADLY ANDERSON
Title or Position: CFO
Credential:
Phone: 262-875-5070