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Family Medicine · West Allis, WI

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At a glance

2514 S 102Nd St Ste 160, West Allis, WI 53227-2142

NPPES record updated Oct 21, 2022. Public records can lag behind changes at a practice.

Before you call: a quick checklist
  • Are you accepting new patients?
  • Do you accept my specific insurance plan?
  • Do you provide the service I need at this address?
  • Do I need a referral, and what is the earliest appointment?

Insurance participation and appointment availability are not established by these public records.

Practice location

2514 S 102Nd St Ste 160
West Allis, WI 53227-2142
Professional details: NPI, taxonomy & registry record
NPI1619594702
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Registry details

Primary taxonomy
Family Medicine
Taxonomy code
207Q00000X
Enumeration date
Jul 6, 2020
Record updated
Oct 21, 2022
More registry details
Provider type
Organization · Type 2
Other reported name
<UNAVAIL>

Reported taxonomies and licenses

Family Medicine

207Q00000X · Primary

Pediatrics

208000000X

Specialty details in registry

208D00000X

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

2514 S 102Nd St Ste 160
West Allis, WI 53227-2142
Phone
(414) 255-0300
Fax
(414) 543-9601
Mailing address
PO BOX 639295 DEPT 93394

CINCINNATI, OH 452639295
Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.

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