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KAGEN DERMATOLOGY CLINIC SC NPI 1730238890


NPI Information

NPI: 1730238890
Provider Name: KAGEN DERMATOLOGY CLINIC SC
Classification: Specialist - 174400000X
Entity Type: Organization

CLIA Number: 52D0397459

Address:
100 W LAWRENCE ST
SUITE 409
APPLETON, WI
ZIP 54911
Phone: (920) 733-5138
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KAGEN DERMATOLOGY CLINIC SC is a specialist in Appleton, WI. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. KAGEN DERMATOLOGY CLINIC SC NPI is 1730238890. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

100 W LAWRENCE ST
SUITE 409
APPLETON, WI
ZIP 54911-773
Phone: (920) 733-5138
Fax: (920) 733-3759

The provider's authorized official is Charles Norman Kagen .
The authorized official title is Physician and has the following contact phone number (920) 733-5138.

The CLIA number assigned to this NPI record is 52D0397459 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 1/9/2007 and was last updated on 8/22/2020.


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
1174400000XSpecialist24388WISCONSINYes

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.