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General NPI Number Information
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NPI Number | 1538018445
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Entity Type | Organization
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Legal Business Name | NORTHSTAR ANESTHESIA OF WISCONSIN LLC
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Dates
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Enumeration Date | 01/23/2026
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Last Update Date | 01/23/2026
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Provider Practice Location Address
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Address Line | 8124 FORSYTHIA ST
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City | MIDDLETON
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State | WI
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Zip | 53562
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Country | US
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Telephone | 608-234-7436
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Fax |
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Provider Business Mailing Address
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Address Line | 6225 N STATE HIGHWAY 161 STE 200
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City | IRVING
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State | TX
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Zip | 75038-2241
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Country | US
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Telephone | 214-687-0001
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOSHUA L LUMBLEY
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Credential | MD
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Telephone | 214-687-0001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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