| Waukesha Family Practice Center | |
|
210 Nw Barstow St Suite 201 Waukesha WI 53188-3771 | |
| (262) 548-6903 | |
| (262) 928-4075 |
| Full Name | Waukesha Family Practice Center |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 210 Nw Barstow St, Waukesha, Wisconsin |
| Authorized Official Name and Position | Chris C Purdy (PROGRAM ADMINISTRATOR) |
| Authorized Official Contact | 2625486916 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Waukesha Family Practice Center 210 Nw Barstow St Suite 201 Waukesha WI 53188-3771 Ph: (262) 548-6903 | Waukesha Family Practice Center 210 Nw Barstow St Suite 201 Waukesha WI 53188-3771 Ph: (262) 548-6903 |
| NPI Number | 1043344203 |
|---|---|
| Provider Enumeration Date | 03/16/2007 |
| Last Update Date | 06/20/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043344203 | NPI | - | NPPES |
| 32739000 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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