Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lake Country Private Medical, SC

Organization Internal Medicine Physician · NPI 1720351919

Lake Country Private Medical, SC is an Internal Medicine Physician in Oconomowoc, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2012.

Licensed in
WI
In the registry since
2012

Practice location Address checks out

1185 Corporate Center Dr Ste 300
Oconomowoc, WI 53066-4887
Phone: (262) 567-5190
Fax: (262) 567-5259
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 48412 (WI)

Record details

NPI number1720351919
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Patrick Fitzgerald — Owner · (262) 567-5190
NPI enumeratedFebruary 17, 2012
Last updated in NPPESMay 18, 2012
Mailing address1185 Corporate Center Dr Ste 300, Oconomowoc, WI 53066-4887

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