Individual
KENNETH R BETTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11051 N SHERMAN RD, EDGERTON, WI 53534-9002
(608) 884-3354
(608) 884-5022
Mailing address
11051 N SHERMAN RD, EDGERTON, WI 53534-9002
(608) 884-3354
(608) 884-5022
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
39870-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457435950
—
WI
Enumeration date
10/24/2006
Last updated
11/03/2020
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