Juile Johnson, MD
Individual provider Active NPI Specialist · Bayside, WI
NPI 1831240407 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1831240407
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 25970 (WI)
- Practice address
- 500 W Brown Deer Rd
Suite 202
Bayside, WI 53217-1618 - Phone
- (414) 434-0461
- NPI assigned
- Jan 12, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prohealth Medical Group Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 25970 | WI | Yes |
Addresses
Primary practice location
500 W Brown Deer Rd
Suite 202
Bayside, WI 53217-1618
Mailing address
3082 Red Fox Cir
Colgate, WI 53017-9544
Other providers in Bayside, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.