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KENOSHA UROLOGY CLINIC S.C. NPI 1396831343


NPI Information

NPI: 1396831343
Provider Name: KENOSHA UROLOGY CLINIC, S.C.
Classification: Urology - 208800000X
Entity Type: Organization
Address:
6308 8TH AVE
SUITE 503
KENOSHA, WI
ZIP 53143
Phone: (262) 656-8213
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KENOSHA UROLOGY CLINIC, S.C. is an urology in Kenosha, WI. The provider is a urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. KENOSHA UROLOGY CLINIC, S.C. NPI is 1396831343. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

6308 8TH AVE
SUITE 503
KENOSHA, WI
ZIP 53143-031
Phone: (262) 656-8213
Fax: (262) 656-8233

The provider's authorized official is Ned R. Novsam .
The authorized official title is Vice-president and has the following contact phone number (262) 656-8213.

The enumeration date for this NPI number is 10/5/2006 and was last updated on 6/3/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208800000XUrology308295WISCONSINYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
132143MEDICARE ID-TYPE UNSPECIFIEDWISCONSIN
20662280001MEDICARE NSCWISCONSIN
332729100MEDICAIDWISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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