Individual
DR. KELLENE VOKATY EAGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1102 S PARK ST, MADISON, WI 53715-1708
(608) 263-3111
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531
(415) 674-6378
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
72455-20
WI
207Q00000X
Family Medicine Physician
A112630
CA
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
72455-20
WI
Other
Enumeration date
11/20/2009
Last updated
12/11/2020
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