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Individual

DR. RICHARD C. LENNERTZ JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2323 N LAKE DR, MILWAUKEE, WI 53211-4508
(414) 291-1000
Mailing address
225 S EXECUTIVE DR, BROOKFIELD, WI 53005-4257
(262) 787-4026
(262) 782-6040

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
25978-020
WI
208VP0014X
Interventional Pain Medicine Physician
Primary
25978
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
050085808
RAIL ROAD MEDICARE
05
30752400
WI
Enumeration date
11/30/2005
Last updated
06/22/2017
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