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Organization
BETTS FAMILY MEDICAL CLINIC, LTD
Active
Organization
BETTS FAMILY MEDICAL CLINIC, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH ROGER BETTS M.D. (OWNER)
(608) 884-2544
Entity
Organization
Contact information
Practice address
528 STOUGHTON RD, EDGERTON, WI 53534-1137
(608) 884-2544
(608) 884-2912
Mailing address
528 STOUGHTON RD, EDGERTON, WI 53534-1137
(608) 884-2544
(608) 884-2912
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
39870020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32445200
—
WI
Enumeration date
03/11/2008
Last updated
03/11/2008
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