Individual
KENT A. HAEFS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
3003 W GOOD HOPE RD, MILWAUKEE, WI 53209-2042
(414) 352-3100
(414) 247-4597
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2612
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38599400
—
WI
01
—
P00465811
RR MEDICARE
WI
Enumeration date
08/24/2006
Last updated
12/23/2025
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