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Individual

JOEL R DEKONING

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
412 CRESCENT DR, WAUSAU, WI 54401-2629
(715) 675-6334
Mailing address
412 CRESCENT DR, WAUSAU, WI 54401-2629

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
19412
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
31129300
WI
Enumeration date
09/20/2006
Last updated
09/13/2010
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