# MILWAUKEE CLINIC OF ORTHO SURGERY, LTD.

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

## Provider details

- **NPI number:** 1295788743
- **Authorized official:** MS. MARY J. BANACH (ADMINISTRATOR)
- **Authorized official phone:** (414) 321-8960

## Contact information

- **Practice address:** 7400 W RAWSON AVE, SUITE 125, FRANKLIN, WI 53132-8278
- **Practice address phone:** (414) 321-8960
- **Practice address fax:** (414) 321-0632
- **Mailing address:** 7400 W RAWSON AVE, SUITE 125, FRANKLIN, WI 53132-8278
- **Mailing address phone:** (414) 321-8960
- **Mailing address fax:** (414) 321-0632

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | WI | Yes |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | WI | — |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | WI | — |

## Other

- **Enumeration date:** 05/18/2006
- **Last updated:** 02/06/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 32738000 | — | WI |