Organization
AFFILIATED ENT, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN J KELLY MD (PRESIDENT)
(414) 475-9300
Entity
Organization
Contact information
Practice address
2500 N MAYFAIR RD STE 450, MILWAUKEE, WI 53226-1443
(414) 475-9300
Mailing address
N87W16462 JACOBSON DR, MENOMONEE FALLS, WI 53051-2833
(262) 255-1040
(262) 255-4090
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
09/01/2006
Last updated
08/22/2020
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