Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 56028 | WI |
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 56028 | WI |
NPI | 1164556684 |
---|---|
Provider Name | Michael Franklin Iossi |
First Address | Milwaukee, WI 53215-3693 |
Second Address | Milwaukee, WI 53215-3693 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2007 |
Last Update Date | 06/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P00989247 | RR MEDICARE (01) | WI |