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Individual

DR. KENNETH SIMONS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
925 N 87TH ST, THE EYE INSTITUTE, MILWAUKEE, WI 53226-4812
(414) 955-2020
(414) 955-6332
Mailing address
925 N 87TH ST, THE EYE INSTITUTE, MILWAUKEE, WI 53226-4812
(414) 955-2020
(414) 955-6332

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
30163
WI
207ZP0101X
Anatomic Pathology Physician
30163
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
002000133
HUMANA
05
1225089709
WI
Enumeration date
05/12/2006
Last updated
01/20/2015
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