Organization
WAUKESHA FAMILY PRACTICE CLINIC, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT J BEAUMONT D.O. (PRESIDENT)
(262) 542-5557
Entity
Organization
Contact information
Practice address
237 WISCONSIN AVE, WAUKESHA, WI 53186-4955
(262) 542-5557
(262) 542-6199
Mailing address
237 WISCONSIN AVE, WAUKESHA, WI 53186-4955
(262) 542-5557
(262) 542-6199
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21266500
—
WI
Enumeration date
09/07/2005
Last updated
04/15/2008
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