Organization
ELMBROOK INTERNAL MEDICINE ASSOCIATES S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS A JOHNSON M.D. (PRESIDENT)
(262) 782-4270
Entity
Organization
Contact information
Practice address
17000 W NORTH AVE, SUITE 200E, BROOKFIELD, WI 53005-4423
(262) 782-4270
(262) 784-9319
Mailing address
17000 W NORTH AVE, SUITE 200E, BROOKFIELD, WI 53005-4423
(262) 782-4270
(262) 784-9319
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
26997
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32742000
—
WI
Enumeration date
09/28/2006
Last updated
08/22/2020
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