Individual
JERALD E CUNDIFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 E MILLER RD, STERLING, IL 61081
(815) 625-4790
Mailing address
800 WEST AVE S, LA CROSSE, WI 54601-8806
(608) 791-9871
(608) 791-7852
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
38957
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
291023300
—
MN
05
—
32545800
—
WI
Enumeration date
10/26/2005
Last updated
07/19/2018
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