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NPI Code Detail

MEDICARE: JEFFREY T. FOLLANSBEE, M.D., S.C.

MEDICARE: JEFFREY T. FOLLANSBEE, M.D., S.C.
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
1207L00000XAnesthesiology Physician32725WI

General Provider Information

NPI Number : 1790005973
Entity Type Code : Organization
Provider Name (Legal Business Name) : JEFFREY T. FOLLANSBEE, M.D., S.C.
Provider Business Mailing Address
First Line : 225 S EXECUTIVE DR
Second Line :
City : BROOKFIELD
State : WI
Zip : 53005-4257
Country : US
Telephone Number : 262-787-4026
Fax Number : 262-782-6040
Provider Business Practice Location Address
First Line : 3915 WEST CAPITOL DRIVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53216-2528
Country : US
Telephone Number : 414-444-9242
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : JEFFREY T FOLLANSBEE
Credential : M.D.
Telephone Number : 262-787-4026
Provider Enumeration Date : 06/10/2010
Last Update Date : 01/29/2015

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