# LINCOLN ORTHOPEDIC GROUP LTD.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225114218
- **Authorized official:** DR. JEFFREY B. SHOVERS M.D. (PRESIDENT)
- **Authorized official phone:** (414) 545-4646

## Contact information

- **Practice address:** 9400 W LINCOLN AVENUE, WEST ALLIS, WI 53227-2306
- **Practice address phone:** (414) 545-4646
- **Practice address fax:** (414) 545-5227
- **Mailing address:** 9400 W LINCOLN AVE, WEST ALLIS, WI 53227-2306
- **Mailing address phone:** (414) 545-4646
- **Mailing address fax:** (414) 545-5227

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204C00000X | Sports Medicine (Neuromusculoskeletal Medicine) Physician | 30083 | WI | Yes |

## Other

- **Enumeration date:** 10/31/2006
- **Last updated:** 08/22/2020