# E JOHN ELDRIDGE MD SC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073610242
- **Authorized official:** EUGENE JOHN ELDRIDGE MD (PRESIDENT)
- **Authorized official phone:** (262) 652-9500

## Contact information

- **Practice address:** 1400 75TH ST, SUITE 3, KENOSHA, WI 53143
- **Practice address phone:** (262) 652-9500
- **Practice address fax:** (262) 652-0760
- **Mailing address:** 1400 75TH ST, SUITE 3, KENOSHA, WI 53143
- **Mailing address phone:** (262) 652-9500
- **Mailing address fax:** (262) 652-0760

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | 25921 | WI | Yes |

## Other

- **Enumeration date:** 09/20/2006
- **Last updated:** 08/22/2020