Organization
SOUTHSIDE PEDIATRICS ASSOC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RANDALL T WESTLEY (OWNER)
(414) 322-3030
Entity
Organization
Contact information
Practice address
2727 W CLEVELAND AVE, MILWAUKEE, WI 53215
(414) 384-9880
(414) 384-0134
Mailing address
2727 W CLEVELAND AVE, MILWAUKEE, WI 53215
(414) 384-9880
(414) 384-0134
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32696700
—
WI
Enumeration date
04/15/2008
Last updated
04/15/2008
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