Organization
AURORA MEDICAL GROUP INC
Active
Organization
AURORA MEDICAL GROUP INC
Active
Other names
Aurora Medical Group Lake Geneva
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFERY BAILET (PRESIDENT)
(414) 647-6322
Entity
Organization
Contact information
Practice address
146 E GENEVA SQ, LAKE GENEVA, WI 53147-9694
(262) 249-5040
(262) 249-7146
Mailing address
5200 VIRGINIA WAY, 4TH FLOOR L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 320-4521
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
332BD1200X
Dialysis Equipment & Supplies (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1336296300
—
WI
Enumeration date
01/04/2007
Last updated
09/22/2010
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