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NPI Code Detail

MEDICARE: MILWAUKEE HEALTH SERVICES INC

MEDICARE: MILWAUKEE HEALTH SERVICES 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
1261QF0400XFederally Qualified Health Center (FQHC)N/A
2333600000XPharmacy8664-42WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1891732244
Entity Type Code : Organization
Provider Name (Legal Business Name) : MILWAUKEE HEALTH SERVICES INC
Provider Business Mailing Address
First Line : 2555 N MARTIN LUTHER KING DR
Second Line :
City : MILWAUKEE
State : WI
Zip : 53212-2709
Country : US
Telephone Number : 414-267-2021
Fax Number : 414-372-7420
Provider Business Practice Location Address
First Line : 8200 W SILVER SPRING DR
Second Line : ATTENTION: TITO IZARD, M.D.
City : MILWAUKEE
State : WI
Zip : 53218-2552
Country : US
Telephone Number : 414-267-2021
Fax Number : 414-372-7420
Authorized Official
Title or Position : PRESIDENT CEO
Name : DR. TITO L IZARD
Credential : M.D.
Telephone Number : 414-267-2021
Provider Enumeration Date : 06/01/2006
Last Update Date : 04/05/2016

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Directions to “MILWAUKEE HEALTH SERVICES INC ” Practice Location

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