Foker, Gregory Robert

Foker, Gregory Robert is an individual health care provider with primary practice located at 5225 N Ironwood Ln , Glendale WI 53217-4909. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is his primary health care specialty. Foker, Gregory Robert can be contacted via phone (414) 962-9156.

Contact Information

Primary practice address
5225 N Ironwood Ln Glendale WI 53217-4909
Phone: (414) 962-9156
Fax: (414) 962-4356
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 12664 Wisconsin
Behavioral Health & Social Service Providers / Professional 101YP2500X 654-125 Wisconsin

Profile Details

NPI number 1073613105
LBN Legal business name Foker, Gregory Robert
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 25th, 2006
Last updated Jul 8th, 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 1073613105 NPPES
Wyoming MEDICAID 39709400

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