| Kevin Douglas Liberty, DPM | |
|
709 Spring Valley Rd, Burlington, WI 53105-7614 | |
| (262) 767-6020 | |
| Not Available |
| Full Name | Kevin Douglas Liberty |
|---|---|
| Gender | Male |
| Speciality | Podiatrist |
| Location | 709 Spring Valley Rd, Burlington, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982243432 | NPI | - | NPPES |
| 100224481 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213E00000X | Podiatrist | SC007059 (Pennsylvania) | Secondary |
| 213E00000X | Podiatrist | 1305 (Wisconsin) | Primary |
| Provider Name | Aurora Medical Group, Inc. |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1427271378 PECOS PAC ID: 6709794258 Enrollment ID: O20031105000725 |
| Mailing Address | Practice Location Address |
|---|---|
| Kevin Douglas Liberty, DPM 3301 W Forest Home Ave, Milwaukee, WI 53215-2843 Ph: () - | Kevin Douglas Liberty, DPM 709 Spring Valley Rd, Burlington, WI 53105-7614 Ph: (262) 767-6020 |
Gerald R Schneider, DPM Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 248 Mchenry St, Burlington, WI 53105 Phone: 767-767-8261 | |
Dr. Jonathan H Hilton, DPM Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 4020 Buena Park Rd, Burlington, WI 53105 Phone: 414-963-0816 | |
Dr. Christopher James Dietzman, DPM Podiatrist Medicare: Medicare Enrolled Practice Location: 1050 Milwaukee Ave Ste 102, Burlington, WI 53105 Phone: 262-763-9007 |