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Organization
WISCONSIN PAIN MANAGEMENT SPECIALISTS, LLC
Active
Organization
WISCONSIN PAIN MANAGEMENT SPECIALISTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL W JUNG MD (CEO)
(262) 412-6799
Entity
Organization
Contact information
Practice address
1050 S. MILWAUKEE AVENUE, SUITE 102, BURLINGTON, WI 53105
(262) 758-6155
Mailing address
PO BOX 135, HARTLAND, WI 53029-0135
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
53681-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208VP0000X
—
WI
Enumeration date
07/09/2018
Last updated
07/24/2019
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