Basic Information
| Provider Information | |||||||||
| NPI: | 1629264692 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | U.S. MEDGROUP, P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5080 SPECTRUM DRIVE | ||||||||
| Address2: | SUITE 1200 WEST | ||||||||
| City: | ADDISON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750014625 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8002323550 | ||||||||
| FaxNumber: | 2147754502 | ||||||||
| Practice Location | |||||||||
| Address1: | 2455 N 124TH ST | ||||||||
| Address2: | |||||||||
| City: | BROOKFIELD | ||||||||
| State: | WI | ||||||||
| PostalCode: | 530054630 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8886226331 | ||||||||
| FaxNumber: | 2628140603 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/24/2007 | ||||||||
| LastUpdateDate: | 09/26/2019 | ||||||||
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| AuthorizedOfficialLastName: | HASSETT | ||||||||
| AuthorizedOfficialFirstName: | ROBERT | ||||||||
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| AuthorizedOfficialTitleorPosition: | EVP, CMO | ||||||||
| AuthorizedOfficialTelephone: | 9723648000 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | DO | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QH0100X | Y | Ambulatory Health Care Facilities | Clinic/Center | Health Service |
No ID Information.