Froedtert South Medical Group

LBN: Froedtert South, Inc.
Froedtert South Medical Group is an health care organization with primary practice located at 6308 8Th Ave , Kenosha WI 53143. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Ambulatory Health Care Facilities / Clinic/Center, Ambulatory Health Care Facilities / Multi-Specialty. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty. Froedtert South, Inc. can be contacted via phone (262) 656-2718, or through Kelley, Thomas J via phone (262) 577-8113.

Contact Information

Primary practice address
6308 8Th Ave Kenosha WI 53143
Fax:
Website:
Authorized official contact:
Name: Kelley, Thomas J

Profile Details

NPI number 1558305284
LBN Legal business name Froedtert South, Inc.
DBA Doing business as Froedtert South Medical Group
Authorized official Kelley, Thomas J
Entity Organization
Organization subpart 1 Yes
Enumeration date Jun 15th, 2006
Last updated Mar 15th, 2023 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558305284 NPPES
Wisconsin MEDICAID 32815500
Wisconsin Other CR0320
Wisconsin Other 213742

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