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Organization
MILWAUKEE HEALTH SERVICES, INC.
Active
Organization
MILWAUKEE HEALTH SERVICES, INC.
Active
Other names
Martin Luther King Heritage Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
TITO L IZARD M.D. (PRESIDENT/CHIEF EXECUTIVE OFFICER)
(414) 372-8080
Entity
Organization
Contact information
Practice address
2555 N MARTIN LUTHER KING DR, MILWAUKEE, WI 53212-2709
(414) 267-3702
(414) 562-8084
Mailing address
2555 N MARTIN LUTHER KING DR, MILWAUKEE, WI 53212-2709
(414) 267-3702
(414) 372-1697
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
8681-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32958200
—
WI
05
—
36228200
—
WI
Enumeration date
07/04/2006
Last updated
08/07/2015
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