OrganizationActive
Lake Country Endoscopy Center, LLC
NPI 1184897472 · Ambulatory Surgical Clinic/Center · Oconomowoc, WI
Provider details
- NPI number
- 1184897472
- Entity type
- Organization
- Primary specialty
- Ambulatory Surgical Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Bao Xiong Thao, Authorized Official(414) 908-6506
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
1185 Corporate Center Dr
Suite 125
Oconomowoc, WI 53066-4845
Phone: (414) 454-0600
Fax: (414) 454-0971
Approximate (ZIP-level) locationGet directions
Mailing address
2801 W Kinnickinnic River Pkwy Ste 1080
Milwaukee, WI 53215-3689
Registry dates
- Enumerated
- 2008-04-08
- Last updated
- 2025-01-08
- Certified
- 2025-01-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.