Children's Medical Group

NPI #1467996991 in Jackson, Wisconsin

Provider Information

NPI Number: 1467996991
Entity Type: Organization
Organization Name: Children's Medical Group
Subpart: Yes (part of a larger organization)
Parent Organization: CHILDREN'S MEDICAL GROUP
Primary Specialty: Pediatrics
Enumeration Date: Dec 19, 2016
Last Updated: Dec 22, 2016

Practice Location

Address: N168W22730 PRAIRIE VIEW LANE
City: Jackson
State: Wisconsin
ZIP Code: 53037
Phone: (262) 423-4800

Authorized Official

Name: SMRITI KHARE, M.D.
Title: PRESIDENT CHILDREN'S MEDICAL GROUP
Phone: (414) 266-7615

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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