Individual
KANE LAKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6749 PINELAKE DR, MADISON, WI 53719-5645
(573) 629-8855
Mailing address
6749 PINELAKE DR, MADISON, WI 53719-5645
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
76397-20
WI
207Q00000X
Family Medicine Physician
8730-851
WI
Other
Enumeration date
04/06/2020
Last updated
11/20/2024
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