Individual
KEVIN L O'HALLORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
123 HOSPITAL DR, SUITE 1008, WATERTOWN, WI 53098-3331
(920) 206-6500
(920) 261-4013
Mailing address
123 HOSPITAL DR, SUITE 1008, WATERTOWN, WI 53098-3331
(920) 206-6500
(920) 261-4013
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
34258
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31932100
—
WI
Enumeration date
08/05/2006
Last updated
09/07/2023
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