| Neurology Center Of Kenosha, S.c. | |
|
704 55th St Kenosha WI 53140-3732 | |
| (262) 656-8888 | |
| (262) 656-8892 |
| Full Name | Neurology Center Of Kenosha, S.c. |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 704 55th St, Kenosha, Wisconsin |
| Authorized Official Name and Position | Robert Walter Jones (PRESIDENT) |
| Authorized Official Contact | 2626568888 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Neurology Center Of Kenosha, S.c. 704 55th St Kenosha WI 53140-3732 Ph: (262) 656-8888 | Neurology Center Of Kenosha, S.c. 704 55th St Kenosha WI 53140-3732 Ph: (262) 656-8888 |
| NPI Number | 1144327792 |
|---|---|
| Provider Enumeration Date | 09/17/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144327792 | NPI | - | NPPES |
| 31381100 | Medicaid | WI | |
| 0500018 | Other | WI | UNITEDHEALTHCARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 29016 (Wisconsin) | Primary |
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