| Dr Larry Davis, MD | |
|
6809 122nd Ave, Kenosha, WI 53142-7335 | |
| (262) 654-8633 | |
| (262) 654-5467 |
| Full Name | Dr Larry Davis |
|---|---|
| Gender | Male |
| Speciality | Pediatrics |
| Location | 6809 122nd Ave, Kenosha, Wisconsin |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699715888 | NPI | - | NPPES |
| 1699715888 | Medicaid | WI | |
| 036104343 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 036-104343 (Illinois) | Secondary |
| 208000000X | Pediatrics | 69544-20 (Wisconsin) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Larry Davis, MD 9000 W Wisconsin Ave # Ms 958, Milwaukee, WI 53226-4874 Ph: (414) 266-7615 | Dr Larry Davis, MD 6809 122nd Ave, Kenosha, WI 53142-7335 Ph: (262) 654-8633 |
Colleen Maroney Johnson, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 8600 75th St Ste 101, Kenosha, WI 53142 Phone: 262-652-9430 Fax: 262-652-9433 | |
Kristen Volkman, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 8500 75th St, Suite 101, Kenosha, WI 53142 Phone: 262-653-2260 | |
Ann Marie Sundareson, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 6809 122nd Ave, Kenosha, WI 53142 Phone: 262-654-8633 Fax: 262-654-5467 | |
Theresa Cafaro, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 6809 122nd Ave, Kenosha, WI 53142 Phone: 262-891-6600 | |
Dr. Ashvini Varadhi Biswas, Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 10400 75th St, Kenosha, WI 53142 Phone: 262-948-5600 Fax: 262-948-5828 | |
Dr. Sheryn Abraham, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 8600 75th St, Ste 101, Kenosha, WI 53142 Phone: 262-652-9430 Fax: 262-652-9433 | |
Gregory W Young, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 6809 122nd Ave, Kenosha, WI 53142 Phone: 262-654-8633 Fax: 262-654-5467 |