Basic Information
| Provider Information | |||||||||
| NPI: | 1578754875 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DAVIS | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | BARTLETT | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | W129N7055 NORTHFIELD DR | ||||||||
| Address2: | REPRODUCTIVE MEDICINE CLINIC | ||||||||
| City: | MENOMONEE FALLS | ||||||||
| State: | WI | ||||||||
| PostalCode: | 530510538 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2622539220 | ||||||||
| FaxNumber: | 4148056622 | ||||||||
| Practice Location | |||||||||
| Address1: | W129N7055 NORTHFIELD DR | ||||||||
| Address2: | REPRODUCTIVE MEDICINE CLINIC | ||||||||
| City: | MENOMONEE FALLS | ||||||||
| State: | WI | ||||||||
| PostalCode: | 530510538 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2622539220 | ||||||||
| FaxNumber: | 4148056622 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/05/2007 | ||||||||
| LastUpdateDate: | 01/05/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 34.009667 | OH | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207VE0102X | 255869 | NY | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Reproductive Endocrinology | 207VE0102X | 60890 | WI | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Reproductive Endocrinology |
ID Information
| ID | Type | State | Issuer | Description | 255869 | 01 | NY | NEW YORK STATE MEDICAL LICENSE | OTHER | 60890-21 | 01 | WI | WISCONSIN STATE MEDICAL BOARD | OTHER | 34.009667 | 01 | OH | STATE OF OHIO | OTHER |