Organization
GREAT LAKES ANESTHESIA AND PAIN SPECIALISTS SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER BOYD BALDOCK (OFFICER AND AUTHORIZED OFFICIAL)
(615) 234-5954
Entity
Organization
Contact information
Practice address
10101 S 27TH ST, FRANKLIN, WI 53132-7209
(414) 817-5800
Mailing address
PO BOX 88829, MILWAUKEE, WI 53288-8829
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
WI
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
WI
Other
Enumeration date
07/27/2009
Last updated
02/19/2025
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