Prohealth Medical Group INC

NPI #1912290909 in Menomonee Falls, Wisconsin

Provider Information

NPI Number: 1912290909
Entity Type: Organization
Organization Name: Prohealth Medical Group INC
Subpart: Yes (part of a larger organization)
Parent Organization: PROHEALTH MEDICAL GROUP INC
Primary Specialty: Internal Medicine
Enumeration Date: May 24, 2011
Last Updated: May 24, 2022

Practice Location

Address: W165N5595 CREEKWOOD XING
City: Menomonee Falls
State: Wisconsin
ZIP Code: 53051-0685
Phone: (262) 373-2600

Authorized Official

Name: JIM LYONS
Title: PRESIDENT
Phone: (262) 928-7636

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X
Internal Medicine - Pulmonary Disease — Pulmonary Disease	207RP1001X
Pathology - Anatomic Pathology & Clinical Pathology — Anatomic Pathology & Clinical Pathology	207ZP0102X
Plastic Surgery	208200000X
Radiology - Diagnostic Radiology — Diagnostic Radiology	2085R0202X
Internal Medicine	207R00000X	Primary

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