Organization
PHYSICIAN ASSOCIATES OF WISCONSIN, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY GERARD NICHOLSON PHD, PA-C (CLINIC MANAGER)
(414) 727-5467
Entity
Organization
Contact information
Practice address
7033 WELLAUER DR, MILWAUKEE, WI 53213-3734
(414) 727-5467
(206) 222-2918
Mailing address
7033 WELLAUER DR, MILWAUKEE, WI 53213-3734
(414) 727-5467
(206) 222-2918
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
11224-20
WI
261Q00000X
Clinic/Center
Primary
904-023
WI
Other
Enumeration date
03/09/2010
Last updated
03/09/2010
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