Individual
KENNETH R. BURG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 W LINCOLN ST, WAUPUN, WI 53963-1949
(920) 324-5577
(920) 324-6288
Mailing address
1 W LINCOLN ST, WAUPUN, WI 53963-1949
(920) 324-5577
(920) 324-6288
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
47945
WI
Other
Enumeration date
05/11/2006
Last updated
11/16/2012
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