Balcom, Anthony H
Balcom, Anthony H is an individual health care provider with primary practice located at 5250 S 108Th St , Hales Corners WI 53130-1321. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Urology, Allopathic & Osteopathic Physicians / Pediatric Urology. Allopathic & Osteopathic Physicians / Pediatric Urology is his primary health care specialty. Balcom, Anthony H can be contacted via phone (414) 525-2400.Contact Information
Primary practice address
5250 S 108Th St
Hales Corners WI 53130-1321
Phone: (414) 525-2400
Fax: (414) 525-2401
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Urology | 208800000X | 26912 | Wisconsin |
| Allopathic & Osteopathic Physicians / Pediatric Urology | 2088P0231X | 26912 | Wisconsin |
Profile Details
| NPI number | 1487604906 |
|---|---|
| LBN Legal business name | Balcom, Anthony H |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 12th, 2006 |
| Last updated | Nov 19th, 2021 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1487604906 | NPPES |
| Wisconsin | MEDICAID | 1487604906 | |
| Wisconsin | Other | 007000261M |
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