Aurora Medical Group, Inc.

Organization Active NPI Obstetrics & Gynecology Physician · West Allis, WI

NPI 1457592735 · NPPES record last updated Mar 16, 2009

Key facts

NPI
1457592735
Entity type
Organization (NPI type 2)
Primary specialty
Obstetrics & Gynecology Physician 207V00000X
Legal business name
AURORA MEDICAL GROUP, INC.
Practice address
8905 W Lincoln Ave
Suite 515
West Allis, WI 53227-2468
Phone
(414) 328-8650
Fax
(414) 328-8660
NPI assigned
Mar 16, 2009
Organization subpart
No

Authorized official

Name
Jeffrey Bailet, MD
Title
President
Phone
(414) 647-6322

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WI

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20031105000725 WI Part B Supplier - Clinic/Group Practice 6709794258 Receives reassigned benefits from 5,043 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207V00000X Yes

Addresses

Primary practice location

8905 W Lincoln Ave
Suite 515
West Allis, WI 53227-2468

Mailing address

8905 W Lincoln Ave
Suite 515
West Allis, WI 53227-2468
Phone (414) 328-8650

Other providers in West Allis, WI

All providers in West Allis, WI · Obstetrics & Gynecology Physician in Wisconsin

Sources for this page

Verify at the official NPI Registry.