Individual
DR. WILLIAM B TISOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2901 W KINNICKINNIC RIVER PKWY STE 507, MILWAUKEE, WI 53215-3660
(414) 649-3780
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(414) 649-3780
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
45072
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
029906261X
HUMANA
—
05
—
34549400
—
WI
Enumeration date
05/15/2006
Last updated
10/17/2023
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