Individual
RODNEY J HALVORSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10400 75TH ST, KENOSHA, WI 53142-7884
(262) 948-7071
Mailing address
10400 75TH ST, KENOSHA, WI 53142-7884
(262) 948-7071
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
31319
WI
207VX0000X
Obstetrics Physician
31319
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31940700
—
WI
Enumeration date
08/28/2006
Last updated
06/13/2014
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