Individual
DR. AUSTIN FRANK BACCHUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
146 E GENEVA SQ, LAKE GENEVA, WI 53147-9694
(262) 249-4660
Mailing address
146 E GENEVA SQ, LAKE GENEVA, WI 53147-9694
(262) 249-4660
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
50490
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34790900
—
WI
Enumeration date
04/25/2007
Last updated
12/03/2021
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