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Organization

ASCENSION MEDICAL GROUP-SOUTHEAST WISCONSIN INC

Active
Other names
Ascension Medical Group
Organization subpart
No

Provider details

NPI number
Authorized official
J. BRYAN FISSEL (VP-FINANCE)
(414) 465-3000
Entity
Organization

Contact information

Practice address
400 W RIVER WOODS PKWY, GLENDALE, WI 53212
(414) 465-3000
Mailing address
400 W RIVER WOODS PKWY, GLENDALE, WI 53212-1060

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
207N00000X
Dermatology Physician
207Q00000X
Family Medicine Physician
207R00000X
Internal Medicine Physician
Primary
207V00000X
Obstetrics & Gynecology Physician
207X00000X
Orthopaedic Surgery Physician
207Y00000X
Otolaryngology Physician
208000000X
Pediatrics Physician
2084N0400X
Neurology Physician
2085R0001X
Radiation Oncology Physician
2085R0202X
Diagnostic Radiology Physician
2086S0129X
Vascular Surgery Physician
208800000X
Urology Physician
363A00000X
Physician Assistant
363L00000X
Nurse Practitioner

Other

Enumeration date
07/31/2006
Last updated
03/28/2023
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