Organization
WISCONSIN MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HALEY KEHOE D.O. (OWNER)
(262) 339-9797
Entity
Organization
Contact information
Practice address
8800 W LINCOLN AVE, WEST ALLIS, WI 53227-2400
(262) 339-9797
Mailing address
14295 WOODMOUNT DR, BROOKFIELD, WI 53005-2390
(262) 339-9797
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5440321
WI
Other
Enumeration date
10/18/2016
Last updated
10/18/2016
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