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General NPI Number Information
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NPI Number | 1558443549
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Entity Type | Organization
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Legal Business Name | GASTROENTEROLOGY SPECIALISTS SC
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 09/22/2025
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Provider Practice Location Address
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Address Line | 1111 DELAFIELD ST STE 321
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City | WAUKESHA
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State | WI
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Zip | 53188-3407
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Country | US
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Telephone | 414-454-0600
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Fax | 414-454-0971
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Provider Business Mailing Address
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Address Line | 2801 W KINNICKINNIC RIVER PKWY STE 1080
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City | MILWAUKEE
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State | WI
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Zip | 53215-3689
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Country | US
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Telephone | 414-908-6506
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Fax | 414-908-6510
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Authorized Official
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Title or Position | DIRECTOR REVENUE MANAGEMENT CYCLE
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Name | AMY JO BURNS
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Credential |
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Telephone | 262-970-7825
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State | WI
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