Individual
KEVIN L EGGLESTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
36500 AURORA DR, SUMMIT, WI 53066-4899
(262) 434-4711
(262) 434-4041
Mailing address
36500 AURORA DR., SUMMIT, WI 53066-4899
(262) 434-4711
(262) 434-4041
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
51420-20
WI
208M00000X
Hospitalist Physician
Primary
51420
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100008169
—
WI
Enumeration date
06/17/2006
Last updated
10/25/2022
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