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General NPI Number Information
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NPI Number | 1588739155
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Entity Type | Organization
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Legal Business Name | MILWAUKEE PSYCHIATRIC PHYSICIANS CHARTERED
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 12760 W NORTH AVE BLDG A
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City | BROOKFIELD
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State | WI
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Zip | 53005-4628
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Country | US
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Telephone | 262-439-5500
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Fax | 866-439-5221
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Provider Business Mailing Address
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Address Line | 12760 W NORTH AVE, BLDG A
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City | BROOKFIELD
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State | WI
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Zip | 53005
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Country | US
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Telephone | 262-439-5500
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Fax | 866-439-5221
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | JACKIE MICHELS
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Credential |
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Telephone | 262-439-5500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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