Individual
EUGENE JOHN ELDRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1400 75TH ST, SUITE 3, KENOSHA, WI 53143-1544
(262) 652-9500
(262) 652-0760
Mailing address
1400 75TH ST, SUITE 3, KENOSHA, WI 53143-1544
(262) 652-9500
(262) 652-0760
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
25921
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31384000
—
WI
Enumeration date
10/26/2006
Last updated
07/08/2007
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