Kewaskum Clinic is a primary clinic (Family Medicine) in Kewaskum, Wisconsin. The current practice location for Kewaskum Clinic is 1701 Fond Du Lac Ave, Kewaskum, Wisconsin. For appointments, you can reach them via phone at
(262) 626-4616. The mailing address for Kewaskum Clinic is 1700 W Paradise Dr, West Bend, Wisconsin and phone number is (262) 334-3451.
Kewaskum Clinic is licensed to practice in * (Not Available) (license number ) and its
NPI number is 1518976919. This medical practice
does not participate in medicare program and thus may not accept your medicare insurance. You may check if they accept your insurance at
(262) 626-4616.
Primary Care Clinic Profile
| Full Name | Kewaskum Clinic |
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| Speciality | Family Medicine |
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| Location | 1701 Fond Du Lac Ave, Kewaskum, Wisconsin |
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| Authorized Official Name and Position | Gregory G Blommel (MEDICAL DIRECTOR) |
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| Authorized Official Contact | 2623343451 |
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| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
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Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Kewaskum Clinic
1700 W Paradise Dr
West Bend
WI 53095-9795
Ph: (262) 334-3451 | Kewaskum Clinic
1701 Fond Du Lac Ave
Kewaskum
WI 53040-9129
Ph: (262) 626-4616 |
NPI Details:
| NPI Number | 1518976919 |
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| Provider Enumeration Date | 08/05/2006 |
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| Last Update Date | 05/23/2012 |
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Medical Identifiers
Medical identifiers for Kewaskum Clinic such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1518976919 | NPI | - | NPPES |
| 21251400 | Medicaid | WI | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 208000000X | Pediatrics | (* (Not Available)) | Secondary |
| 2085B0100X | Radiology - Body Imaging | (* (Not Available)) | Secondary |
| 332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Secondary |
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