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Organization
PREMIER CARDIOVASCULAR INSTITUTE OF WISCONSIN LLC
Active
Organization
PREMIER CARDIOVASCULAR INSTITUTE OF WISCONSIN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OBRAD KOKANOVIC M.D. (OWNER)
(406) 750-8202
Entity
Organization
Contact information
Practice address
1309 S 54TH ST, MILWAUKEE, WI 53214-3404
(406) 750-8202
Mailing address
2500 W LAYTON AVE, SUITE 200, MILWAUKEE, WI 53221-5420
(406) 750-8202
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
51767
WI
Other
Enumeration date
11/17/2014
Last updated
01/27/2015
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