Wisconsin Psychiatric Services, Ltd | |
1035 W Glen Oaks Ln Suite 204 Mequon WI 53092-3392 | |
(262) 512-9400 | |
Not Available |
Full Name | Wisconsin Psychiatric Services, Ltd |
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Speciality | Psychiatry & Neurology |
Location | 1035 W Glen Oaks Ln, Mequon, Wisconsin |
Authorized Official Name and Position | Wess R Vogt (PRESIDENT) |
Authorized Official Contact | 2625129400 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Wisconsin Psychiatric Services, Ltd Po Box 639 Cedarburg WI 53012-0639 Ph: (262) 512-9400 | Wisconsin Psychiatric Services, Ltd 1035 W Glen Oaks Ln Suite 204 Mequon WI 53092-3392 Ph: (262) 512-9400 |
NPI Number | 1245346733 |
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Provider Enumeration Date | 08/21/2006 |
Last Update Date | 09/10/2013 |
Medicare PECOS PAC ID | 8527226463 |
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Medicare Enrollment ID | O20120222001002 |
Identifier | Type | State | Issuer |
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1245346733 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | (* (Not Available)) | Secondary |
Provider Name | Wess R Vogt |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1023124708 PECOS PAC ID: 0143110783 Enrollment ID: I20040317001474 |
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