MEDICARE: JOHN S LANHAM DPM & ASSOCIATES SC

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	213E00000X	Podiatrist	750	WI

General Provider Information

NPI Number	:	1699967505
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHN S LANHAM DPM & ASSOCIATES SC

Provider Business Mailing Address
First Line	:	5720 W OKLAHOMA AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53219-4301
Country	:	US
Telephone Number	:	414-541-5566
Fax Number	:	414-541-6022

Provider Business Practice Location Address
First Line	:	5720 W OKLAHOMA AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53219-4301
Country	:	US
Telephone Number	:	414-541-5566
Fax Number	:	414-541-6022

Authorized Official
Title or Position	:	PODIATRIST
Name	:	DR. JOHN STUART LANHAM
Credential	:
Telephone Number	:	414-541-5566

Provider Enumeration Date	:	08/14/2007
Last Update Date	:	08/14/2007

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