Provider Demographics
NPI:1134460066
Name:BRANKO PRPA MD LLC
Entity Type:Organization
Organization Name:BRANKO PRPA MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRANKO
Authorized Official - Middle Name:
Authorized Official - Last Name:PRPA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:262-456-1070
Mailing Address - Street 1:6233 BANKERS RD
Mailing Address - Street 2:SUITE 11
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:WI
Mailing Address - Zip Code:53403-9700
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6233 BANKERS RD
Practice Address - Street 2:SUITE 11
Practice Address - City:MOUNT PLEASANT
Practice Address - State:WI
Practice Address - Zip Code:53403-9700
Practice Address - Country:US
Practice Address - Phone:262-456-1070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-01
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty