MEDICARE: LAUREN WEASLER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	69989-20	WI

General Provider Information

NPI Number	:	1013449685
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN WEASLER MD

Provider Business Mailing Address
First Line	:	1369 N PORT WASHINGTON RD STE 362
Second Line	:
City	:	GRAFTON
State	:	WI
Zip	:	53024-9333
Country	:	US
Telephone Number	:	414-375-5135
Fax Number	:	414-363-4460

Provider Business Practice Location Address
First Line	:	1369 N PORT WASHINGTON RD STE 362
Second Line	:
City	:	GRAFTON
State	:	WI
Zip	:	53024-9333
Country	:	US
Telephone Number	:	414-375-5135
Fax Number	:	414-363-4460

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/01/2017
Last Update Date	:	08/07/2025

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