Individual
DR. CULLEN TIMOTHY KEHOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
N2950 STATE ROAD 67, LAKE GENEVA, WI 53147-2655
(262) 245-4990
(262) 245-2248
Mailing address
N2950 STATE ROAD 67, LAKE GENEVA, WI 53147-2655
(262) 245-4990
(262) 245-2248
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
036122047
IL
207P00000X
Emergency Medicine Physician
11215
ND
207P00000X
Emergency Medicine Physician
Primary
53435-21
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1013166925
BCBSWI
WI
05
—
1013166925
—
WI
01
—
KEHOECUL
MERCYCARE INSURANCE
WI
Enumeration date
09/16/2008
Last updated
04/28/2025
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