institution
Kenosha Family Practice, S.c.
Health Service Clinic/Center in Kenosha, Wisconsin
NPI 1982770095

Kenosha Family Practice, S.c. is a Health Service Clinic/Center based in Kenosha, WI and is specialized in Health Service. Kenosha Family Practice, S.c. practices in Kenosha, WI. The NPI Number for Kenosha Family Practice, S.c. is 1982770095 and holds a License No. 30201 (Wisconsin).

The current practice location address for Kenosha Family Practice, S.c. is 5923 Green Bay Rd, Kenosha, WI and can be reached out via phone at 262-652-0500 and via fax at 262-652-1928.

Location: 5923 Green Bay Rd, Kenosha, WI, 53144-3737
institution
Provider Profile Details
NPI Number
1982770095
Provider Name
Kenosha Family Practice, S.c.
Credential
Provider Entity Type
Organization
Address
5923 Green Bay Rd, Kenosha, WI, 53144-3737
Phone Number
262-652-0500
Fax Number
262-652-1928
Provider Enumeration Date
11/28/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
21270500 05 WI
DA2461 01 RAILROAD MEDICARE
institution
Provider Business Practice Location Address Details
Address
5923 Green Bay Rd
City
State
Zip
53144-3737
Phone Number
262-652-0500
Fax Number
262-652-1928
person
Provider Business Mailing Address Details
Address
5923 Green Bay Rd
City
State
Zip
53144-3737
Phone Number
262-652-0500
Fax Number
262-652-1928
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Health Service
Taxonomy
License No.
30201 (Wisconsin)
Definition
Definition to come...
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