Organization
AURORA MEDICAL GROUP, INC.
Active
Other names
Aurora Sheboygan Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY W BAILET (PRESIDENT)
(414) 647-6322
Entity
Organization
Contact information
Practice address
2414 KOHLER MEMORIAL DR, SHEBOYGAN, WI 53081-3129
(920) 457-4461
Mailing address
2414 KOHLER MEMORIAL DR, SHEBOYGAN, WI 53081-3129
(920) 457-4461
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32718000
—
WI
05
—
42193100
—
WI
Enumeration date
01/04/2007
Last updated
08/22/2008
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