Organization
BETTS FAMILY MEDICAL CLINIC, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH ROGER BETTS M.D. (OWNER)
(608) 884-2544
Entity
Organization
Contact information
Practice address
528 STOUGHTON RD, EDGERTON, WI 53534-1137
(608) 884-2544
(608) 884-2912
Mailing address
528 STOUGHTON RD, EDGERTON, WI 53534-1137
(608) 884-2544
(608) 884-2912
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
39870020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32445200
—
WI
Enumeration date
03/11/2008
Last updated
03/11/2008
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