Organization
KEVIN L O'HALLORAN MD SC
Active
Other names
Orthopedic Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN L O'HALLORAN MD (OWNER)
(920) 261-0672
Entity
Organization
Contact information
Practice address
123 HOSPITAL DR, SUITE 1008, WATERTOWN, WI 53098-3331
(920) 261-0672
(920) 261-0682
Mailing address
123 HOSPITAL DR, SUITE 1008, WATERTOWN, WI 53098-3331
(920) 261-0672
(920) 261-0682
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
34258
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31932100
—
WI
Enumeration date
08/05/2006
Last updated
02/26/2009
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