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General NPI Number Information
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NPI Number | 1912959156
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Entity Type | Organization
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Legal Business Name | RJC MEDICAL SERVICES, S.C.
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 08/31/2011
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Provider Practice Location Address
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Address Line | 1111 DELAFIELD ST SUITE 219
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City | WAUKESHA
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State | WI
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Zip | 53188-3403
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Country | US
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Telephone | 262-951-8508
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Fax | 262-565-0340
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Provider Business Mailing Address
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Address Line | PO BOX 1423
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City | WAUKESHA
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State | WI
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Zip | 53187-1423
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Country | US
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Telephone | 262-951-8508
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Fax | 262-565-0340
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Authorized Official
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Title or Position | PRESIDENT
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Name | RONALD J COOPER
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Credential | M.D.
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Telephone | 262-951-8508
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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