Individual
DR. KENT CARLTON SCHAEFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1520 N MEADE ST, APPLETON, WI 54911-3762
(920) 734-7181
(920) 734-0621
Mailing address
3113 W TWIN WILLOW CT, APPLETON, WI 54914-6645
(920) 832-1260
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
32613
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32155400
—
WI
Enumeration date
08/16/2005
Last updated
07/30/2012
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