Provider Demographics
NPI:1982726659
Name:MILWAUKEE ENT SPEECH & HEARING AID SERVICE
Entity type:Organization
Organization Name:MILWAUKEE ENT SPEECH & HEARING AID SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:GOGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:262-241-8000
Mailing Address - Street 1:10945 N PORT WASHINGTON ROAD
Mailing Address - Street 2:SUITE 211
Mailing Address - City:MEQUON
Mailing Address - State:WI
Mailing Address - Zip Code:53092
Mailing Address - Country:US
Mailing Address - Phone:262-241-8000
Mailing Address - Fax:262-241-8096
Practice Address - Street 1:10945 N PORT WASHINGTON ROAD
Practice Address - Street 2:SUITE 211
Practice Address - City:MEQUON
Practice Address - State:WI
Practice Address - Zip Code:53092
Practice Address - Country:US
Practice Address - Phone:262-241-8000
Practice Address - Fax:262-241-8096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2010-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment