Gary J Leo, DO | |
2311 N Prospect Ave, Milwaukee, WI 53211-4445 | |
(414) 319-3000 | |
(414) 319-3033 |
Full Name | Gary J Leo |
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Gender | Male |
Speciality | Psychiatry & Neurology - Neurology |
Location | 2311 N Prospect Ave, Milwaukee, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1336182237 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084N0400X | Psychiatry & Neurology - Neurology | 23807 (Wisconsin) | Primary |
Entity Name | Ascension Medical Group-southeast Wisconsin Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1609881077 PECOS PAC ID: 8628980943 Enrollment ID: O20031104000421 |
Entity Name | Columbia St Marys Hospital Milwaukee Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1023064482 PECOS PAC ID: 5890604722 Enrollment ID: O20031105000057 |
Mailing Address | Practice Location Address |
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Gary J Leo, DO 4425 N Port Washington Rd, Csmcp Clinic Credentialing, Glendale, WI 53212-1082 Ph: (414) 319-3000 | Gary J Leo, DO 2311 N Prospect Ave, Milwaukee, WI 53211-4445 Ph: (414) 319-3000 |
Christopher R Takala, DO Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 9000 W Wisconsin Ave, Pediatric Psychiatry, Milwaukee, WI 53226 Phone: 414-607-5280 | |
Mr. Joseph S. Goveas, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 1155 N Mayfair Rd, Department Of Psychiatry, Milwaukee, WI 53226 Phone: 414-955-8900 Fax: 414-955-6285 | |
Dr. Bhupendra O Khatri, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 3237 S 16th St, Milwaukee, WI 53215 Phone: 414-769-4040 Fax: 414-769-4041 | |
Joshua E Medow, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 9200 W Wisconsin Ave, Neurocritical Care, Milwaukee, WI 53226 Phone: 414-805-8710 Fax: 414-805-1101 | |
Gina G Negrette, MD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 820 N Plankinton Ave, Milwaukee, WI 53203 Phone: 414-273-1991 | |
Dr. John Pankiewicz, M.D. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 821 W State St, Suite 504, Milwaukee, WI 53233 Phone: 414-278-4690 Fax: 414-223-1817 | |
Biana Kotlyar, M.D. Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 2323 N Lake Dr, 1st Floor, Milwaukee, WI 53211 Phone: 414-291-1620 Fax: 414-291-5969 |