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NPI Code Detail

MEDICARE: AURORA MEDICAL GROUP, INC

MEDICARE: AURORA MEDICAL GROUP, INC
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
1261QM1300XMulti-Specialty Clinic/Center
2261QA1903XAmbulatory Surgical Clinic/Center

General Provider Information

NPI Number : 1144273913
Entity Type Code : Organization
Provider Name (Legal Business Name) : AURORA MEDICAL GROUP, INC
Provider Business Mailing Address
First Line : 3000 W MONTANA ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53215-3628
Country : US
Telephone Number : 414-647-3047
Fax Number :
Provider Business Practice Location Address
First Line : 4061 OLD PESHTIGO RD
Second Line :
City : MARINETTE
State : WI
Zip : 54143-3887
Country : US
Telephone Number : 715-732-8000
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : JEFFREY W BAILET
Credential : MD
Telephone Number : 414-647-3047
Provider Enumeration Date : 05/19/2006
Last Update Date : 04/04/2013

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