Individual
DR. ALAN P. GEGENHEIMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
9697 SAINT CATHERINES DR, SUITE 200, PLEASANT PRAIRIE, WI 53158-2118
(262) 656-3590
(262) 656-3591
Mailing address
6308 8TH AVE, ATTN: MEDICAL STAFF OFFICE, KENOSHA, WI 53143-5031
(262) 656-3313
(262) 653-5850
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
036-099781
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1730119561
—
WI
Enumeration date
07/04/2006
Last updated
08/09/2016
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