Organization
WISCONSIN SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VISHAL LAL (EXECUTIVE DIRECTOR)
(414) 325-3737
Entity
Organization
Contact information
Practice address
3305 S 20TH ST, STE 150, MILWAUKEE, WI 53215
(414) 384-2100
(414) 384-2700
Mailing address
PO BOX 210140, 4131 W LOOMIS RD STE 300, GREENFIELD, WI 53221
(414) 325-3725
(414) 325-3720
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41913800
—
WI
Enumeration date
07/01/2006
Last updated
08/22/2020
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