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

Dr. George T Poullette, MD

Individual provider Family Medicine Physician · NPI 1104933415

Dr. George T Poullette, MD is a Family Practice in Pleasant Prairie, Wisconsin. Graduated from University of Wisconsin School of Medicine in 1988, 38 years ago. Practices with Advantage Physical Therapy and Sports Rehab, LLC, a 286-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
38
Trained at
University of Wisconsin School of Medicine
Licensed in
WI
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

10256 Old Green Bay Rd
Pleasant Prairie, WI 53158-2815
Phone: (262) 551-4200
Fax: (262) 551-4947
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 30486 (WI)

Record details

NPI number1104933415
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedAugust 23, 2006
Last updated in NPPESMarch 7, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolUNIVERSITY OF WISCONSIN SCHOOL OF MEDICINE
Graduated 1988 (38 years in practice)
Group practice Advantage Physical Therapy And Sports Rehab, Llc — 286 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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