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Individual

EMERSON KENDALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
525 E MAIN ST APT 306, MADISON, WI 53703-2905
(616) 560-4730
Mailing address
525 E MAIN ST APT 306, MADISON, WI 53703-2905
(616) 560-4730

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
5151013622
MI
207W00000X
Ophthalmology Physician
Primary
81140
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5151013622
MI
Enumeration date
06/04/2019
Last updated
07/12/2024
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