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Individual

KENNETH J MACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
600 HIGHLAND AVE, MADISON, WI 53792-0001
(608) 890-6500
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
31065
WI
2084N0400X
Neurology Physician
44001
MN
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
31065
WI
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
44001
MN

Other

Enumeration date
12/28/2005
Last updated
03/15/2024
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