Provider Demographics
NPI:1619920394
Name:O'GRADY, JOSEPH P JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:P
Last Name:O'GRADY
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:8701 WATERTOWN PLANK ROAD
Mailing Address - Street 2:MEDICAL COLLEGE OF WISCONSIN DEPT OF PSYCHIATRY
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226
Mailing Address - Country:US
Mailing Address - Phone:414-955-8950
Mailing Address - Fax:414-955-6295
Practice Address - Street 1:8701 WATERTOWN PLANK ROAD
Practice Address - Street 2:MEDICAL COLLEGE OF WISCONSIN DEPT OF PSYCHIATRY
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226
Practice Address - Country:US
Practice Address - Phone:414-955-8950
Practice Address - Fax:414-955-6295
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2014-05-20
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Provider Licenses
StateLicense IDTaxonomies
WI231742084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1619920394Medicaid
002000218JOtherHUMANA
B55457Medicare UPIN
WI1619920394Medicaid