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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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