Organization
LINCOLN ORTHOPEDIC GROUP LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY B. SHOVERS M.D. (PRESIDENT)
(414) 545-4646
Entity
Organization
Contact information
Practice address
9400 W LINCOLN AVENUE, WEST ALLIS, WI 53227-2306
(414) 545-4646
(414) 545-5227
Mailing address
9400 W LINCOLN AVE, WEST ALLIS, WI 53227-2306
(414) 545-4646
(414) 545-5227
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
30083
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31506100
—
WI
Enumeration date
10/31/2006
Last updated
08/22/2020
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