Baccus, Donald J

Baccus, Donald J is an individual health care provider with primary practice located at 17280 W North Ave Suite 200, Brookfield WI 53045-4366. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gynecology, which is considered as his primary health care specialty. Baccus, Donald J can be contacted via phone (262) 754-8000.

Contact Information

Primary practice address
17280 W North Ave Suite 200 Brookfield WI 53045-4366
Phone: (262) 754-8000
Fax: (262) 754-8008
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gynecology 207VG0400X 21134 Wisconsin

Profile Details

NPI number 1538152962
LBN Legal business name Baccus, Donald J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2005
Last updated Jul 9th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538152962 NPPES
Wisconsin MEDICAID 30313100
Wisconsin MEDICAID 32666500

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