Provider Type Icon

PREMISE HEALTH OF WISCONSIN MEDICAL S.C. NPI 1912690439


NPI Information

NPI: 1912690439
Provider Name: PREMISE HEALTH OF WISCONSIN MEDICAL, S.C.
Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

CLIA Number: 52D2166605

Address:
7601 DISCOVERY DR
MIDDLETON, WI
ZIP 53562
Phone: (608) 338-0400
Get Directions

PREMISE HEALTH OF WISCONSIN MEDICAL, S.C. is a multi-specialty clinic center in Middleton, WI. PREMISE HEALTH OF WISCONSIN MEDICAL, S.C. NPI is 1912690439. The provider is registered as an organization entity type.

The provider's business location address is:

7601 DISCOVERY DR
MIDDLETON, WI
ZIP 53562-528
Phone: (608) 338-0400
Fax: (608) 824-8817

The provider's authorized official is Jonathan Leizmaan .
The authorized official title is President and has the following contact phone number (615) 468-6270.

The CLIA number assigned to this NPI record is 52D2166605 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/31/2023 and was last updated on 5/31/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM1300XClinic/CenterMulti-SpecialtyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.