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Organization
MILWAUKEE EAR NOSE THROAT CLINIC LIMITED
Active
Organization
MILWAUKEE EAR NOSE THROAT CLINIC LIMITED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT JOSEPH GOGAN (CEO)
(262) 241-8000
Entity
Organization
Contact information
Practice address
10945 N PORT WASHINGTON RD STE 211, MEQUON, WI 53092-5078
(262) 241-8000
(262) 241-8096
Mailing address
10945 N PORT WASHINGTON RD, SUITE 211, MEQUON, WI 53092-5078
(262) 241-8000
(262) 241-8096
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
—
—
207YS0123X
Facial Plastic Surgery Physician
Primary
—
—
231H00000X
Audiologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30326800
—
WI
01
—
C01734
RRB
WI
Enumeration date
01/30/2007
Last updated
01/07/2020
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