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Individual

DR. EMILY LOUISE EXTEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
6408 COPPS AVE, MONONA, WI 53716-3702
(608) 417-3000
Mailing address
335 GLESSNER AVE, MANSFIELD, OH 44903-2269
(608) 417-6000

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
35.129789
OH
207X00000X
Orthopaedic Surgery Physician
Primary
52635
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1205051141
WI
Enumeration date
04/16/2007
Last updated
01/25/2022
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