Individual
DR. MITCHELL KELLY EDQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
2024-00266
NC
2085R0202X
Diagnostic Radiology Physician
Primary
83308-20
WI
Other
Enumeration date
04/08/2019
Last updated
07/23/2025
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