Organization
PREMIER RADIOLOGY WISCONSIN, LLC
Active
Other names
Ascension Premier Radiology
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL MCCULLOUGH (CFO)
(414) 465-3736
Entity
Organization
Contact information
Practice address
10180 WASHINGTON AVE STE 101, MOUNT PLEASANT, WI 53177-1604
(414) 973-7830
(414) 793-7831
Mailing address
PO BOX 713302, CHICAGO, IL 60677-1320
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
09/19/2019
Last updated
01/22/2025
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