Michael J. Phillips, M.D., S.C.

Primary specialty

Clinical Pathology/Laboratory Medicine PhysicianTaxonomy code 207ZP0105X

Legal business name

MICHAEL J. PHILLIPS, M.D., S.C.

Practice address

791 E Summit Ave
Oconomowoc, WI 53066-3844

Phone

(262) 569-0619

Fax

(262) 569-0697

NPI assigned

Nov 23, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michael J Phillips, M.D.

Title

President

Phone

(262) 569-0619

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Laboratory Pathology Services Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1033192091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 INDUSTRIAL LOOP",
            "city": "GREENDALE",
            "state": "WI",
            "postal_code": "531292452",
            "telephone_number": "414-423-4100",
            "fax_number": "414-423-4134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "791 E SUMMIT AVE",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530663844",
            "telephone_number": "262-569-0619",
            "fax_number": "262-569-0697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL J. PHILLIPS, M.D., S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "262-569-0619",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ZP0105X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32778900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Laboratory Pathology Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Medical Eye Associates, S.C.
• Alisha F Mell, OT
• Michael S Messer, D.D.S.
• Micayla Meyers Madell, DNP
• Sarah Meyers, CCC-SLP
• Michael Jay Phillips, MD, SC
• Michael R Traub D.C. LTD
• James A Michaels, DDS
• Midwest Health Services Inc
• Michelle M Mielke, MD

• Clinical Pathology/Laboratory Medicine Physician in Oconomowoc, WI
• Providers in Oconomowoc, WI by specialty
• Clinical Pathology/Laboratory Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.