# PROHEALTH MEDICAL GROUP INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PROHEALTH MEDICAL GROUP INC
- **Other names:** ProHealth Care Medical Associates
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1912290909
- **Legal business name:** PROHEALTH MEDICAL GROUP INC
- **Authorized official:** JIM LYONS (PRESIDENT)
- **Authorized official phone:** (262) 928-7636

## Contact information

- **Practice address:** W165N5595 CREEKWOOD XING, MENOMONEE FALLS, WI 53051-0685
- **Practice address phone:** (262) 373-2600
- **Mailing address:** N17W24100 RIVERWOOD DR, SUITE 250, WAUKESHA, WI 53188-1177
- **Mailing address phone:** (262) 928-6225

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 207RP1001X | Pulmonary Disease Physician | — | NULL | — |
| 207RP1001X | Pulmonary Disease Physician | — | — | — |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | NULL | — |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | — | — |
| 208200000X | Plastic Surgery Physician | — | NULL | — |
| 208200000X | Plastic Surgery Physician | — | — | — |
| 2085R0202X | Diagnostic Radiology Physician | — | NULL | — |
| 2085R0202X | Diagnostic Radiology Physician | — | — | — |

## Other

- **Enumeration date:** 05/24/2011
- **Last updated:** 05/24/2022